Cerebral Haemodynamics: Effects of Systemic Arterial Pulsatile Function and Hypertension

  • Alberto Avolio
  • Mi Ok Kim
  • Audrey Adji
  • Sumudu Gangoda
  • Bhargava Avadhanam
  • Isabella Tan
  • Mark Butlin
Blood Pressure Monitoring and Management (J Cockcroft, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Blood Pressure Monitoring and Management


Purpose of Review

Concepts of pulsatile arterial haemodynamics, including relationships between oscillatory blood pressure and flow in systemic arteries, arterial stiffness and wave propagation phenomena have provided basic understanding of underlying haemodynamic mechanisms associated with elevated arterial blood pressure as a major factor of cardiovascular risk, particularly the deleterious effects of isolated systolic hypertension in the elderly. This topical review assesses the effects of pulsatility of blood pressure and flow in the systemic arteries on the brain. The review builds on the emerging notion of the “pulsating brain”, taking into account the high throughput of blood flow in the cerebral circulation in the presence of mechanisms involved in ensuring efficient and regulated cerebral perfusion.

Recent Findings

Recent studies have provided evidence of the relevance of pulsatility and hypertension in the following areas: (i) pressure and flow pulsatility and regulation of cerebral blood flow, (ii) cerebral and systemic haemodynamics, hypertension and brain pathologies (cognitive impairment, dementia, Alzheimer’s disease), (iii) stroke and cerebral small vessel disease, (iv) cerebral haemodynamics and noninvasive estimation of cerebral vascular impedance, (v) cerebral and systemic pulsatile haemodynamics and intracranial pressure, (iv) response of brain endothelial cells to cyclic mechanical stretch and increase in amyloid burden.


Studies to date, producing increasing epidemiological, clinical and experimental evidence, suggest a potentially significant role of systemic haemodynamic pulsatility on structure and function of the brain.


Cerebral haemodynamics Pulse pressure Arterial stiffness Cerebral autoregulation Cyclic stretch Microvascular damage Cognitive impairment Amyloid beta 



This study was funded by the Australian Research Council Linkage Grant (LP150100614).

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Alberto Avolio
    • 1
  • Mi Ok Kim
    • 1
  • Audrey Adji
    • 1
    • 2
  • Sumudu Gangoda
    • 1
  • Bhargava Avadhanam
    • 1
  • Isabella Tan
    • 1
  • Mark Butlin
    • 1
  1. 1.Department of Biomedical Sciences, Faculty of Medicine and Health SciencesMacquarie UniversitySydneyAustralia
  2. 2.St. Vincent’s Clinic, Victor Chang Cardiac Research InstituteUniversity of New South WalesSydneyAustralia

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