Roles of hypertension in the rupture of intracranial aneurysms

Research output: Contribution to journalArticle

Authors

  • Yoshiteru Tada
  • Kosuke Wada
  • Kenji Shimada
  • Hiroshi Makino
  • Elena I. Liang
  • Shoko Murakami
  • Mari Kudo
  • Keiko T. Kitazato
  • Shinji Nagahiro
  • Tomoki Hashimoto

External Institution(s)

  • University of California at San Francisco
  • Tokushima University

Details

Original languageEnglish (US)
Pages (from-to)579-586
Number of pages8
JournalStroke
Volume45
Issue number2
StatusPublished - Feb 1 2014
Peer-reviewedYes

Abstract

Background and Purpose - Systemic hypertension has long been considered a risk factor of aneurysmal rupture. However, a causal link between systemic hypertension and the development of aneurysmal rupture has not been established. In this study, using a mouse model of intracranial aneurysm rupture, we examined the roles of systemic hypertension in the development of aneurysmal rupture. Methods - Aneurysms were induced by a combination of deoxycorticosterone acetate (DOCA)-salt and a single injection of elastase into the cerebrospinal fluid in mice. Antihypertensive treatment was started 6 days after aneurysm induction. Aneurysmal rupture was detected by neurological symptoms and confirmed by the presence of intracranial aneurysm with subarachnoid hemorrhage. Hydralazine (direct vasodilator) or discontinuation of DOCA-salt treatment was used to assess the roles of systemic hypertension. Captopril (angiotensin-converting enzyme inhibitor) or losartan (angiotensin II type 1 receptor antagonist) was used to assess the roles of the local renin-angiotensin system in the vascular wall. Results - Normalization of blood pressure by hydralazine significantly reduced the incidence of ruptured aneurysms and the rupture rate. There was a dose-dependent relationship between reduction of blood pressure and prevention of aneurysmal rupture. Captopril and losartan were able to reduce rupture rate without affecting systemic hypertension induced by DOCA-salt treatment. Conclusions - Normalization of blood pressure after aneurysm formation prevented aneurysmal rupture in mice. In addition, we found that the inhibition of the local renin-angiotensin system independent from the reduction of blood pressure can prevent aneurysmal rupture.

    Research areas

  • Angiotensins, Hypertension, Intracranial aneurysm, Models, animal, Subarachnoid hemorrhage

Citation formats

APA

Tada, Y., Wada, K., Shimada, K., Makino, H., Liang, E. I., Murakami, S., ... Hashimoto, T. (2014). Roles of hypertension in the rupture of intracranial aneurysms. Stroke, 45(2), 579-586. https://doi.org/10.1161/STROKEAHA.113.003072

Harvard

Tada, Y, Wada, K, Shimada, K, Makino, H, Liang, EI, Murakami, S, Kudo, M, Kitazato, KT, Nagahiro, S & Hashimoto, T 2014, 'Roles of hypertension in the rupture of intracranial aneurysms', Stroke, vol. 45, no. 2, pp. 579-586. https://doi.org/10.1161/STROKEAHA.113.003072