Arterial spin labeling MRI in assessing cerebral blood flow changes due to hypertension: a systematic review

Hypertension is a significant risk factor for cerebrovascular diseases, affecting cerebral blood flow (CBF) and brain health. Reduced CBF in hypertensive individuals is linked to cognitive decline and neurodegenerative diseases. Arterial spin labeling (ASL) MRI offers a noninvasive method to assess these changes. This systematic review consolidates evidence on the impact of hypertension on CBF using ASL-MRI. A comprehensive search across PubMed, Scopus, Embase, and Web of Science, following PRISMA 2020 guidelines, included studies on adults with hypertension reporting CBF measurements. Findings indicate that hypertension reduces CBF in various brain regions, with improvements seen after antihypertensive treatment. ASL-MRI may be a valuable tool for monitoring treatment effectiveness and brain health. However, most studies were conducted in high-income countries and elderly populations, emphasizing the need for further research in younger and low-income settings. Early CBF assessment using ASL-MRI could aid in timely interventions.