ESOC 2023 | The effect of intensive blood pressure treatment on brain perivascular spaces

Kyle Kern, MD, National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, MD, reports on recent research aiming to investigate how intensive blood pressure treatment effects brain perivascular spaces. Volume fractions for both the perivascular spaces in supratentorial white matter and basal ganglia regions were determined. A mixed-effects model was chosen, whereby age, white matter hyperintensity volume, chronic kidney disease, cardiovascular disease, and blood pressure were all co-variables. The results of this study showed intensive blood pressure treatment slightly reduced the perivascular space volume, relative to the control group. Perivascular spaces could be linked to neurodegenerative processes. Previous studies have shown arterial stiffening associated with high blood pressure and there is some evidence to suggest stiffening of the blood vessels may lead to reduced circulation in the glymphatic system. It is possible that intensive blood pressure treatment could reverse the changes seen from old age and high blood pressure. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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