Cerebral hemodynamics in patients with heart failure associated and hypertension and the response to treatment.

Cerebral blood flow and cerebral oxygen consumption are not altered in patients with uncomplicated hypertension (1). Scheinberg observed that in a mixed group of patients who had congestive heart failure, the cerebral blood flow was depressed (2). This suggests altered cerebral hemodynamics either as a primary abnormality or as a result of disturbances in the cerebral circulatory dynamics secondary to the cardiac failure. Novack, Goluboff, Bortin, Soffe, and Shenkin (3) studying the same problem concluded that the cerebral blood flow is not depressed to any greater extent in patients with heart failure than it would be in a similar group of patients of the same age group who were not in heart failure. Since cerebral blood flow and cerebral oxygen consumption are relatively normal (1, 4) in patients with essential hypertension which is uncomplicated by the co-existence of heart failure, it seemed worth making observations on cerebral hemodynamics in a group of patients with hypertension who had developed heart failure. Since all but three of these patients were under the age of sixty years, if a significant reduction in cerebral blood flow were found, it could then be considered to be a result of the heart failure rather than secondary to cerebral arteriosclerosis. In addition, observations were made on the cerebral hemodynamic response when twelve patients were given maximum therapy for heart failure. If cerebral blood flow and oxygen consumption were depressed because of heart failure, one might well have expected these functions to improve following treatment.