Antihypertensive Treatment Improves Microvascular Rarefaction and Reactivity in Low-Risk Hypertensive Individuals

作者：Kaiser Sergio E; Sanjuliani Antonio F; Estato Vanessa; Gomes Marilia B; Tibirica Eduardo^*

来源：Microcirculation, 2013, 20(8): 703-716.

DOI：10.1111/micc.12067

• video capillaroscopy
• capillary rarefaction
• microvascular dysfunction
• hypertension

ObjectiveTo test whether long-term antihypertensive treatment with metoprolol succinate (a (1)-adrenoceptor blocker) or olmesartan medoxomil (an angiotensin II AT(1)-receptor blocker) reverses microvascular dysfunction in hypertensive patients.
MethodsThis study included 44 hypertensive outpatients and 20 age and sex-matched healthy controls. We used skin capillaroscopy to measure capillary density and recruitment at rest and during PORH. Endothelium-dependent vasodilation of skin microcirculation was evaluated with a LDPM system in combination with ACh iontophoresis, PORH, and LTH.
ResultsPretreatment capillary density in hypertensive patients was significantly reduced compared with controls (71.31.5 vs. 80.6 +/- 1.8cap/mm(2); p<0.001), as was PORH (71.7 +/- 1.5 vs. 79.5 +/- 2.6cap/mm(2); p<0.05). After treatment for six months, capillary density increased to 75.4 +/- 1.1cap/mm(2) (p<0.01) at rest and 76.8 +/- 1.1cap/mm(2) during PORH. During LTH, CVC in perfusion units (PU)/mmHg was similar in patients (1.71 [1.31-2.12]) and controls (1.60 [1.12-1.91]) and increased significantly (1.82 [1.30-2.20]) after treatment. Maximal CVC during PORH was reduced in hypertensive patients (0.30 [0.22-0.39]) compared to controls (0.39 [0.31-0.49], p<0.001) and increased (0.41 [0.29-0.51], p<0.001) after treatment.
ConclusionsCapillary rarefaction and microvascular endothelial dysfunction in hypertensive patients responded favorably to long-term pharmacological treatment.

• 出版日期2013-11