Abstract
Although hypertensive patients show significant elevation of blood pressure (BP) in acute phase after cerebral infarction, it is still unknown how it should be managed to carry the best prognosis. To address this issue, we investigated the effect of acute control of elevated BP by bilateral renal denervation (RD) against ischemic stroke in SHRSP rats with 90 minutes transient middle cerebral arterial occlusion (MCAO). Seventy-five male SHRSP rats of 15 weeks of age were assigned to sham-operated (control, n = 15) and MCAO + sham (sham, n = 30), and MCAO + RD (RD, n = 30). Bilateral RD was done approximately 30 minutes after ischemia induction. In experiment 1, we evaluated the acute effects of RD by measurement of continuous BP, cerebral blood flow (CBF), cerebral vascular resistance (CVR), vasoreactivity by acetazolamide, neurological function, and infarct volume. In addition, phosphorylated Akt and e-NOS, and oxidative stress using gp91phox and dihydroethidium in ischemic brain were also evaluated at 24 hours after ischemia induction. In experiment 2, temporal changes of body weight of the rats were measured in every week and also rotarod test were assessed around 4 weeks after ischemia induction. Although the ischemic rats in sham group showed severe hypertension, RD significantly reduced BP through 24 hours after ischemia induction. The value of CBF after reprefusion was significantly lower in RD group compared to sham group, while CVR and vasoreactivity was not changed by RD. RD significantly ameliorated neurological deficit and infarct volume. Moreover, RD reduced not only the level of phosphorylated Akt and e-NOS but also oxidative stress. In experiment 2, body weight and rotarod test showed significant increasing in RD group compared to sham group. Our results suggest that acute blood pressure control by RD is promising therapeutic strategy to improve prognosis after ischemic stroke in hypertensive patients.
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