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Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Disproportionally impaired microvascular structure in essential hypertension
Ashkan Eftekhari1, Ole Norling Mathiassen, Niels Henrik Buus
1Department of Medicine and Cardiology A, Aarhus University Hospital, Skejby Sygehus, Aarhus N, Denmark.
Journal of Hypertension
|February 19, 2011
Summary
Essential hypertension involves excessive microvascular changes that occur early, not just as an adaptation to high blood pressure. These microvascular impairments are not accurately reflected by the blood pressure level alone.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Essential hypertension is characterized by increased microvascular resistance and small artery remodeling.
- Investigating the relationship between coronary and forearm minimum vascular resistances (C-Rmin and F-Rmin) and hypertension severity is crucial.
Purpose of the Study:
- To examine the correlation between impaired coronary and forearm minimum vascular resistances and the degree of essential hypertension.
- To determine if microvascular alterations in hypertension are an early phenomenon or solely an adaptation to elevated blood pressure.
Main Methods:
- Seventy-five never-treated essential hypertension patients (grades 1 and 2) and 25 normotensive controls were studied.
- Coronary and forearm minimum vascular resistances (C-Rmin, F-Rmin) were measured using echocardiography and plethysmography.
- Coronary flow reserve (CFR), systemic vascular resistance index (SVRI), and left-ventricular mass were also assessed.
Main Results:
- Both C-Rmin and F-Rmin were significantly elevated in hypertensive groups, exceeding expected increases based on blood pressure levels.
- Coronary flow reserve (CFR) was reduced by approximately 30% in both essential hypertension groups.
- Systemic vascular resistance index (SVRI) and left-ventricular mass increased proportionally with blood pressure elevation.
Conclusions:
- Hypertension is associated with excessive and early microvascular structural abnormalities.
- The degree of blood pressure elevation does not accurately indicate the extent of microvascular impairment in essential hypertension.
- Microvascular alterations appear to be an early pathophysiological event in essential hypertension.
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