Nail-fold capillaroscopy in the study of microcirculation in elderly hypertensive patients

Hypertension represents one of the most important atherosclerotic risk factors, since it causes vascular damage both to macro- and microcirculation. Capillaroscopy is very useful to examine "in vivo" the small vessels of nail-fold and conjunctival layer of the bulb which are the most suitable areas for a morphological study of microcirculation. Capillaroscopy gives remarkable information from a clinical and diagnostic point of view, both in the diseases involving microcirculation (connective tissue disorders, diabetes) and in the evaluation of microvascular impairments in systemic diseases such as arterial hypertension. Aim of the present study was at evaluating capillaroscopic characteristics in a consecutive and non-selected series of elderly hypertensive patients and comparing the results to those observed on fundus oculi. Our study revealed the decrease of the number of capillary loops which appear thin and lengthened, in the hypertensive persons, as compared to the control group. Dilated and tortuous capillaries, arteriovenous sludge and "flea bite" juxtacapillary microhemorrhages were found more frequently in the patients with isolated systolic hypertension; they are linked to the atherosclerotic nature of that disease.