To evaluate the effect of valsartan treatment on cerebrovascular reactivity (CVR) in patients with arterial hypertension (AH) and rheumatoid arthritis (RA).Design and method:
Subjects were 34 patients with AH and RA (male/female 1/33, age 61 [54; 64] yrs, SBP/DBP 142 [131; 149]/79 [77; 90] mmHg). Valsartan (40–320 mg/day) was administered for 24 weeks. CVR was evaluated by bilateral transcranial Doppler sonography (TCD) of the middle cerebral arteries (MCA) in hypercapnia (HC) before (W0) and after 24 weeks valsartan treatment (W24). We measured MCA time average maximal blood flow velocity (TAMX), peak systolic velocity (Vps) at baseline, during 2 min inhalation of the 4% mixture of carbonic gas with air (CO2) and during 3 min recovery phase. Values are presented as Me [25; 75 percentiles].Results:
MCA TAMX, Vps were increased during 2 minutes of CO2 inhalation, but did not return to baseline values in the recovery phase before treatment (Figure). Valsartan normalized both systolic and diastolic BP since the first month (P < 0.01). During CO2 inhalation MCA TAMX and Vps did not differ significantly between W0 and W24. Values of MCA blood flow velocities were significantly lower after valsartan treatment compared with W0 in the 3–5 minutes recovery period (P < 0.02).Conclusions:
According to the results of MCA TCD, valsartan treatment improved CVR in patients with AH and RA by normalizing the MCA blood flow velocities in the recovery phase of CO2 test.