The Beat Goes On: imaging brain artery stiffness and the damage caused by poor buffering of pulsatile blood flow

Every heartbeat sends a pressure wave through the arteries, and as people age, their brain vessels stiffen and can no longer absorb that pulse—allowing damaging energy to leak into delicate capillaries. This matters because the resulting damage to the blood-brain barrier is strongly linked to small vessel disease, stroke, and many forms of dementia. Yet no existing technology can track pulsatile blood flow across the brain’s entire vascular tree, from large arteries down to capillaries. Without that ability, researchers cannot determine exactly how arterial stiffness progresses in the brain or how it triggers neural degeneration. This project will build a Cerebrovascular Stiffness Toolbox—a set of advanced MRI techniques that can link vessel stiffness at every scale to capillary-level damage. It will then map how healthy and compromised buffering changes during ageing and hypertension. Finally, it will compare four acute interventions that alter vascular stiffness through different mechanisms: two classes of anti-hypertensive drugs (ACE inhibitors vs. calcium channel blockers) and two forms of dietary nitrate (organic vs. inorganic). The goal is to identify which approach best prevents brain arterial stiffening. If successful, this could transform how clinicians monitor and treat vascular contributions to dementia and stroke, moving from managing blood pressure alone to actively protecting the brain’s microcirculation.