The Cerebral Vasculature Adapts to Chronic High Blood Pressure

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In conditions of chronic hypertension, cerebral vascular resistance increases, thereby allowing cerebral blood flow and, presumably, capillary pressures to be normal. The adaptation of cerebral vessels to sustained hypertension lets them maintain vasoconstriction at arterial pressures that would overcome the contractile ability of a normal vascula-ture (Fig. 17.2).

The mechanisms that enable the cerebral vasculature to adjust the autoregulatory range upward appear to be hypertrophy of the vascular smooth muscle and a mechanical constraint to vasodilation, as a result of more muscle tissue, o 150

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