Arterial Remodeling of the Intracranial Arteries in Patients With Hypertension and Controls

Abstract

The intracranial arteries play a major role in cerebrovascular disease, but arterial remodeling due to hypertension has not been well described in humans. We aimed to quantify this remodeling for: the basilar artery, the vertebral, internal carotid, middle/anterior (inferior)/posterior cerebral, posterior communicating, and superior cerebellar arteries of the circle of Willis. Ex vivo circle of Willis specimens, selected from individuals with (n=24) and without (n=25) a history of hypertension, were imaged at 7T magnetic resonance imaging using a 3-dimensional gradient-echo sequence. Subsequently, histological analysis was performed. We validated the vessel wall thickness and area measurements from magnetic resonance imaging against histology. Next, we investigated potential differences in vessel wall thickness and area between both groups using both techniques. Finally, using histological analysis, we investigated potential differences in arterial wall stiffness and atherosclerotic plaque severity and load. All analyses were unadjusted. Magnetic resonance imaging and histology showed comparable vessel wall thickness (mean difference: 0.04 mm (limits of agreement:−0.12 to 0.19 mm) and area (0.43 mm 2 [−0.97 to 1.8 mm 2 ]) measurements. We observed no statistically significant differences in vessel wall thickness and area between both groups using either technique. Histological analysis showed early and advanced atherosclerotic plaques in almost all arteries for both groups. The arterial wall stiffness was significantly higher for the internal carotid artery in the hypertensive group. Concluding, we did not observe vessel wall thickening in the circle of Willis arteries in individuals with a history of hypertension using either technique. Using histological analysis, we observed a difference in vessel wall composition for the internal carotid artery.

Effect of long-term antihypertensive treatment on cerebrovascular structure and function in hypertensive rats

“…We focussed on the arteries because morphological and mechanical changes of the resistance arteries are often considered a hallmark of hypertension 16 . Multiple animal studies demonstrated that hypertension is associated with remodelling of the cerebral resistance arteries 17 – 19 , which was also shown in human studies more recently 20 , 21 . Generally, hypertension leads to an increased wall-to-lumen ratio, which can be seen as an adaptation to reduce wall stress.…”

Association Between Behavioral, Biological, and Genetic Markers of Cardiovascular Health and MRI Markers of Brain Aging

“… 24 , 25 These cardiometabolic risk factors could remodel structure of cerebral blood vessels, thus limiting blood flow, facilitating arteriosclerosis, and reducing oxygen and glucose to the brain. 26 , 27 Therefore, it is biologically plausible that favorable biological CVH profiles are associated with vascular brain health. We did not find any association of CVH profiles with annual PVS changes.…”

Risk factors associated with hemorrhagic cerebrovascular accident: A cross-sectional study in patients from a hospital in Peru

“…Recently, researchers evidenced increased stiffness and histological changes in the inner wall of the internal carotid artery in patients with hypertension. [ 32 ] So, there could be a link between hypertension, arterial calcification, and CVA. Mak et al [ 33 ] identified a high degree of calcification associated with intracranial atherosclerosis and CVA.…”