Impaired Intracranial Compliance: A New Hypertension-Mediated Brain Organ Damage?

INTRODUCTION

Hypertension-mediated organ damage (HMOD) is well established in the heart, kidneys, and vasculature; however, early markers of cerebral involvement remain poorly defined.

AIM: This multicenter, cross-sectional Brazilian study investigated impaired intracranial compliance (ICC) across hypertension (HT) stages in adults without neurological disease or antihypertensive therapy, aiming to characterize early cerebral hemodynamic changes potentially related to hypertension-mediated brain organ damage.

METHODS

ICC was assessed noninvasively from intracranial pressure (ICP) waveforms using the P2/P1 ratio and time-to-peak (TTP).

RESULTS

A total of 252 participants were included (52.4% men, 87.7% < 65 years). Mean P2/P1 and TTP values were 1.32 and 0.25, respectively. Significant differences were found between prehypertension and stage 2 HT (p < 0.001) and between stage 1 and 2 (p < 0.05) for P2/P1, as well as between prehypertension and stage 2 for TTP (p < 0.05). The Jonckheere-Terpstra test confirmed a progressive increase in both parameters across HT stages. Women presented higher values of P2/P1 and TTP in all stages.

CONCLUSIONS

These findings suggest early and progressive impairment of ICC with increasing blood pressure, supporting its potential relevance as an early marker of cerebrovascular dysfunction, especially in women.