Decreased CSF Dynamics in Treatment-Naive Patients with Essential Hypertension: A Study with Phase-Contrast Cine MR Imaging

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FIG 1.
Flow chart of the study population.
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FIG 2.
Illustration of the location of phase-contrast MR imaging planes. The midline sagittal T1WI MR image shows the phase-contrast MR imaging planes (solid line) located at the ampulla level of the cerebral aqueduct and perpendicular to its long axis (dotted line).
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FIG 3.
Placement of ROI to contain the whole aqueduct.
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FIG 4.
Flow curves of the essential hypertension and control groups. Flows are plotted during the successive phases of a cardiac cycle time (millisecond) and expressed in milliliter/minute. Each flow curve for both groups represents average flow values. Positive deflections represent craniocaudal flow (CSF systole), and negative deflections represent caudocranial flow (CSF diastole).

Table 1:

Clinical characteristics of patients with essential hypertension and healthy subjects

Characteristics	Patients	Controls	P Value
No.	60	60
Age (mean) (yr)	61.24 (SD, 8.9)	60.38 (SD, 7.54)	.84
Male	31	33	.71
PP (mean) (mm Hg)	53.78 (SD, 14.86)	42.43 (SD, 4.36)	<.001
SBP (mean) (mm Hg)	148.54 (SD, 13.55)	123.40 (SD, 6.06)	.001
DBP (mean) (mm Hg)	94.76 (SD, 7.72)	80.97 (SD, 2.42)	<.001
Disease duration (mean) (yr)	4.92 (SD, 2.72)	0	<.001

Table 2:

Comparison of mean CSF flow parameters in the hypertension and control groups

Group	FFV (mL)	FPV (cm/s)	RFV (mL)	RPV (cm/s)	AF (mL/min)	NFV (mL)
Patients	0.054 (SD, 0.021)	5.338 (SD, 2.024)	0.042 (SD, 0.019)	4.837 (SD, 2.196)	7.480 (SD, 3.221)	0.012 (SD, 0.005)
Controls	0.080 (SD, 0.040)	6.197 (SD, 2.394)	0.070 (SD, 0.042)	5.823 (SD, 2.821)	9.824 (SD, 5.435)	0.010 (SD, 0.011)
P value	<.001	.04	.005	.04	.006	.12

Table 3:

Univariate linear regression coefficients for relationships between hypertension parameters and CSF flow parameters^{^a}

Variables	FFV (mL)^{^b}	FPV (cm/s)^{^b}	RFV (mL)^{^b}	RPV (cm/s)^{^b}	AF (mL/min)^{^b}
Duration	−0.81 (−0.98 to −0.64)^{^c}	−0.83 (−0.99 to −0.67)^{^c}	−0.84 (−0.99 to −0.68)^{^c}	−0.83 (−0.99 to −0.67)^{^c}	−0.77 (−0.95 to −0.58)^{^c}
PP	−0.76 (−0.95 to −0.57)^{^c}	−0.73 (−1.01 to −0.71)^{^c}	−0.74 (−0.94 to −0.55)^{^c}	−0.25 (−1.01−0.03)^{^c}	−0.74 (−0.94 to −0.54)^{^c}
SBP	−0.86 (−1.01 to −0.71)^{^c}	−0.86 (−0.97 to −0.62)^{^c}	−0.88 (−1.02 to −0.75)^{^c}	−0.87 (−0.75 to −0.72)^{^c}	−0.83 (−0.99 to −0.67)^{^c}
DBP	0.05 (−0.33−0.25)	−0.10 (−0.39−0.19)	−0.12 (−0.41−0.17)	−0.11 (−0.40−0.18)	0.04 (−0.33−0.25)
Age	−0.13 (−0.42−0.16)	−0.05 (−0.34−0.24)	−0.11 (−0.40−0.18)	−0.09 (−0.38−0.20)	−0.07 (−0.36−0.22)
Sex	−0.09 (−0.38−0.20)	−0.10 (−0.38−0.19)	−0.12 (−0.41−0.17)	−0.11 (−0.40−0.18)	−0.14 (−0.43−0.15)

↵a Numbers in parentheses are 95% CI.
↵b Crude regression coefficients indicative of increase (positive value) or decrease (negative value) in CSF flow parameters.
↵c P < .05.

Table 4:

Multiple linear regression coefficients for relationships between hypertension parameters and CSF flow parameters^{^a}

Variables	FFV (mL)^{^b}	FPV (cm/s)^{^b}	RFV (mL)^{^b}	RPV (cm/s)^{^b}	AF (mL/min)^{^b}
Duration	−0.34 (−0.61 to −0.07)^{^c}	−0.37 (−0.64 to −0.10)^{^c}	−0.31 (−0.56 to −0.07)^{^c}	−0.35 (−0.61 to −0.09)^{^c}	−0.25 (−0.55−0.05)^{^c}
SBP	−0.44 (−0.83 to −0.06)^{^c}	−0.50 (−0.88 to −0.12)^{^c}	−0.61 (−0.97 to −0.26)^{^c}	−0.55 (−0.91 to −0.18)^{^c}	−0.50 (−0.93 to −0.08)^{^c}
PP	−0.25 (−0.43−0.13)^{^c}	−0.16 (−0.33−0.22)^{^c}	−0.11 (−0.26−0.25)^{^c}	−0.23 (−0.30−0.24)^{^c}	−0.34 (−0.45−0.17)^{^c}

↵a Numbers in parentheses are 95% CI.
↵b β, adjusted regression coefficients indicative of an increase (positive value) or decrease (negative value) in CSF flow parameters.
↵c P < .05.