Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Evaluation of cerebral blood flow by single-photon emission computed tomography in young Asian Indians with hypertension

Journal of Human Hypertension volume 20, pages 143–148 (2006)Cite this article

Abstract

The objective of the study was to investigate abnormalities of regional cerebral blood flow (rCBF) in young (age 33.0±6.3 years; range 21–45 years) non-diabetic and normolipidemic Asian Indians with hypertension. The rCBF was assessed with single-photon emission computed tomography (SPECT) in patients with hypertension (n=33) and healthy controls (n=20). The SPECT findings were normal in 41 subjects and showed abnormalities of cerebral perfusion in 10 subjects, all of which were hypertensive patients. These observations are extremely important for a vast number of young hypertensive patients in India. To prevent cerebrovascular accidents in future, patients with hypertension and decreased rCBF should be carefully monitored and their hypertension should be strictly controlled. These subjects may also be researched as potential candidates for preventive antiplatelet therapy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Stamler J, Stamler R, Neaton JD . Blood pressure, systolic and diastolic, and cardiovascular risks: US population data. Arch Intern Med 1993; 153: 598–615.

    Article  CAS  Google Scholar 

  2. Kannel WB . Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA 1996; 275: 1571–1576.

    Article  CAS  Google Scholar 

  3. Sagie A, Larson MG, Levy D . The natural history of borderline isolated systolic hypertension. N Engl J Med 1993; 329: 1912–1917.

    Article  CAS  Google Scholar 

  4. MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J et al. Blood pressure, stroke, and coronary heart disease. Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765–774.

    Article  CAS  Google Scholar 

  5. Neaton JD, Wentworth D . Serum cholesterol, blood pressure, cigarette smoking, and death from coronary artery disease: overall findings and differences by age for 316 099 white men. Arch Intern Med 1992; 152: 56–64.

    Article  CAS  Google Scholar 

  6. Van den Hoogen PC, Feskens EJ, Nagelkerke NJ, Menotti A, Nissinen A, Kromhout D . The relation between blood pressure and mortality due to coronary heart disease among men in different parts of the world. N Engl J Med 2000; 342: 1–8.

    Article  CAS  Google Scholar 

  7. Shaw TG, Mortel KF, Meyer JS, Rogers RL, Hardenberg J, Cutaia MM . Cerebral blood flow changes in benign aging and cerebrovascular disease. Neurology 1984; 34: 855–862.

    Article  CAS  Google Scholar 

  8. Meyer JS, Rogers RL, Mortel KF . Prospective analysis of long-term control of mild hypertension on cerebral blood flow. Stroke 1985; 16: 985–989.

    Article  CAS  Google Scholar 

  9. Rogers RL, Meyer JS, Shaw TG, Mortel KF . Reductions in cerebral blood flow associated with chronic consumption of alcohol. J Am Geriatr Soc 1983; 31: 540–543.

    Article  CAS  Google Scholar 

  10. Meyer JS, Rogers RL, Mortel KF . Progressive cerebral ischemia antedates cerebrovascular symptoms by two years. Ann Neurol 1984; 16: 314–320.

    Article  CAS  Google Scholar 

  11. Rogers RL, Meyer JS, Mortel KF, Mahurin RK, Judd BW . Decreased cerebral blood flow precedes multi-infarct dementia, but follows senile dementia of Alzheimer's type. Neurology 1986; 36: 1–6.

    Article  CAS  Google Scholar 

  12. Efimova IIu, Astanina IA, Kolodina MV . Cerebral microcirculation and structural changes in the brain in essential hypertension. Klin Med (Mosk) 2004; 82: 16–19.

    Google Scholar 

  13. Claudiani F, Stimamiglio P, Castello C, Villavecchia G, Cabria M, Bertolazzi L . Semiquantitative evaluation of regional cerebral flow by means of SPECT with 99mTc-hexamethyl-propylene amine oxime in hypertensive patients under treatment. J Nucl Biol Med 1993; 37: 1–5.

    CAS  PubMed  Google Scholar 

  14. Gupta R . Trends in hypertension epidemiology in India. J Hum Hypertens 2004; 18: 73–78.

    Article  CAS  Google Scholar 

  15. Dey J, Misra A, Desai NG, Mahapatra AK, Padma MV . Cognitive function in younger type II diabetes. Diabetes Care 1997; 20: 32–35.

    Article  CAS  Google Scholar 

  16. Sinha S, Misra A, Kumar V, Jagannathan NR, Bal CS, Pandey RM et al. Proton magnetic resonance spectroscopy and single photon emission computed tomography study of the brain in asymptomatic young hyperlipidaemic Asian Indians in North India show early abnormalities. Clin Endocrinol (Oxf) 2004; 61: 182–189.

    Article  CAS  Google Scholar 

  17. Dudeja V, Misra A, Pandey RM, Devina G, Kumar G, Vikram NK . Body mass index does not accurately predict overweight in Asian Indians in Northern India. Br J Nutr 2001; 86: 105–112.

    Article  CAS  Google Scholar 

  18. Freidwald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifugation. Clin Chem 1972; 18: 499–502.

    Google Scholar 

  19. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 1–21.

  20. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997; 157: 2413–2446.

  21. Diabetes mellitus. Report of a WHO Study Group. Technical Report Series, no. 727, 1985.

  22. World Health Organization. The Asia–Pacific Perspective. Redefining obesity and its treatment. International Diabetes Institute, February 2000.

  23. Hortobagyi T, Israel RG, O’Brien KF . Sensitivity and specificity of the Quetelet index to assess obesity in men and women. Eur J Clin Nutr 1994; 48: 769–775.

    Google Scholar 

  24. Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight. N Engl J Med 1999; 341: 427–434.

    Article  CAS  Google Scholar 

  25. O’Brien TJ, Zupanc ML, Mullan BP, O’Connor MK, Brinkmann BH, Cicora KM et al. The practical utility of performing peri-ictal SPECT in the evaluation of children with partial epilepsy. Pediatr Neurol 1998; 19: 15–22.

    Article  Google Scholar 

  26. Treves ST, Connolly LP . Single photon emission computed tomography (SPECT) in pediatric epilepsy. Neurosurg Clin N Am 1995; 6: 473–480.

    Article  CAS  Google Scholar 

  27. Costa D C, Ell P J, Cullum I D, Jarritt P H . The in vivo distribution of 99mTc HMPAO in normal man. Nucl Med Commun 1996; 7: 647–658.

    Article  Google Scholar 

  28. Links JM . Optimization of acquisition parameters for brain SPECT. In: Weber DA, Devous MD, Tikofksy RS, Woodhead AD, Vivirito KJ (eds). Workshop on Brain SPECT Perfusion Imaging: Image Acquisition, Processing, Display, and Interpretation. US Government Printing Office; Washington, DOE CONF-9110368, 1992, pp 28–32.

    Google Scholar 

  29. Eastern Stroke and Coronary Heart Disease Collaborative Research Group. Blood pressure, cholesterol, and stroke in eastern Asia. Lancet 1998; 352: 1801–1807.

  30. Adams RD, Victor M . Cerebrovascular diseases. In: Adams RD, Victor M (eds). Principles of Neurology. McGraw-Hill Inc. Press: USA, 1993, pp 669–748.

    Google Scholar 

  31. Phillips SJ, Whisnant JP . Hypertension and the brain. The National High Blood Pressure Education Program. Arch Intern Med 1992; 152: 938–945.

    Article  CAS  Google Scholar 

  32. Misra A . Atherosclerosis in Indians and lipoprotein (a). J Assoc Physicians India 1999; 47: 313–317.

    CAS  PubMed  Google Scholar 

  33. Misra A, Luthra K, Vikram NK . Dyslipidemia in Asian Indians: determinants and significance. J Assoc Physicians India 2004; 52: 137–142.

    CAS  PubMed  Google Scholar 

  34. Misra A . C-reactive protein in young individuals: problems and implications for Asian Indians. Nutrition 2004; 20: 478–481.

    Article  CAS  Google Scholar 

  35. Misra A, Vikram NK, Pandey RM, Dwivedi M, Ahmad FU, Luthra K et al. Hyperhomocysteinemia, and low intakes of folic acid and vitamin B12 in urban North India. Eur J Nutr 2002; 41: 68–77.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We express our appreciation to the staff of metabolic and body composition research group including Mr Inder Taneja, Mr Gian Chand, and Mrs Alice Jacob. We also express our thanks to all the technicians of the Department of Nuclear Medicine who helped in this study.

Conflict of interest: none.

Author information

Authors and Affiliations

  1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

    S Sinha, A Misra & S Tiwari

  2. Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

    C S Bal & N K Gouda

  3. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    R M Pandey

Authors
  1. S Sinha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A Misra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C S Bal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N K Gouda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R M Pandey
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Tiwari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to S Sinha or A Misra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sinha, S., Misra, A., Bal, C. et al. Evaluation of cerebral blood flow by single-photon emission computed tomography in young Asian Indians with hypertension. J Hum Hypertens 20, 143–148 (2006). https://doi.org/10.1038/sj.jhh.1001946

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001946

Keywords

Search

Advanced search

Quick links