{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T18:51:43Z","timestamp":1777747903840,"version":"3.51.4"},"reference-count":24,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2014]]},"abstract":"<b><i>Background:<\/i><\/b> Hypertension is associated with cognitive deficits, particularly executive function, and decreased cerebral microvascular responsiveness to CO<sub>2<\/sub> (CO<sub>2<\/sub> vasoreactivity). The relation between CO<sub>2<\/sub> vasoreactivity and executive function is not known. Protocols to assess CO<sub>2<\/sub> vasoreactivity are cumbersome and require inhaling a CO<sub>2<\/sub>-enriched gas. We explored the ability to measure CO<sub>2<\/sub> vasoreactivity using end-tidal CO<sub>2<\/sub> fluctuations during normal breathing and the association of this measure with cognitive function in hypertension. <b><i>Methods:<\/i><\/b> Executive function (Trail-Making Test parts A\/B), memory, attention and blood flow velocity (BFV) in the middle cerebral artery using transcranial Doppler were measured in hypertensive subjects who were tapered off their treatment for 3 weeks. BFV was measured while sitting and normally breathing for 5 min, followed by breathing 5% CO<sub>2<\/sub> gas and hyperventilation for 2 min each. We calculated CO<sub>2<\/sub> vasoreactivity as the rate of BFV change from hypoventilation to hyperventilation, and as a model-derived measure using the normal breathing data. The latter was derived using nonlinear principal dynamic modes (PDM), which modelled the dynamic effect of fluctuations in end-tidal CO<sub>2<\/sub> and blood pressure upon BFV during normal room-air respiration. Multiple regression analyses were used to correlate cerebral hemodynamics with cognitive measures. <b><i>Results:<\/i><\/b> Data were collected from 41 individuals with hypertension (mean age 71 years, 24% African Americans, 61% women, off antihypertensive therapy). Lower CO<sub>2<\/sub> vasoreactivity was associated with a worse executive function test score using both calculation methods: p value using the hyper\/hypoventilation data was 0.04 and from the PDM analysis was 0.009. PDM calculations showed a stronger correlation with executive function (0.41 vs. 0.21 using the hyper\/hypoventilation data). There were no associations with memory or attention measures. There was a weak but statistically significant correlation between the two calculation methods of CO<sub>2<\/sub> vasoreactivity (R<sup>2<\/sup> = 14%, p = 0.02). <b><i>Conclusion:<\/i><\/b> This study suggests that the decrease in CO<sub>2<\/sub> vasoreactivity in hypertension is associated with lower executive function. This may offer new insight into the vascular underpinning of cognitive decline in hypertension. We demonstrate that calculating CO<sub>2<\/sub> vasoreactivity is possible during normal breathing. If replicated in future studies, this may offer a more convenient clinical way to assess CO<sub>2<\/sub> vasoreactivity in hypertension and cognitive disorders.<\/jats:p>","DOI":"10.1159\/000365349","type":"journal-article","created":{"date-parts":[[2014,8,20]],"date-time":"2014-08-20T06:53:29Z","timestamp":1408517609000},"page":"10-16","source":"Crossref","is-referenced-by-count":30,"title":["Assessment of Cerebrovascular Reactivity during Resting State Breathing and Its Correlation with Cognitive Function in Hypertension"],"prefix":"10.1159","volume":"38","author":[{"given":"Ihab","family":"Hajjar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasilis","family":"Marmerelis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae C.","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Chui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2014,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.161"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-6175.2005.04498.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000097642"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.160002"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.487165"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.12.2895"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(03)00947-6"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.8.1897"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002348"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1993.79.4.0483"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1159\/000015943"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2009.5334057"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/823525"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199009000-00004"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-9-48"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.64.5.588"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(197204)28:2<167::AID-JCLP2270280212>3.0.CO;2-X"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(198707)43:4<402::AID-JCLP2270430411>3.0.CO;2-E"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-013-0837-z"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-012-0736-8"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2004.834272"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1159\/000015944"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-012-0736-8"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1159\/000158817"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/365349","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/365349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:58:12Z","timestamp":1745431092000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000365349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2014,9,1]]},"published-print":{"date-parts":[[2014,10,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000365349","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}