Essential hypertension is closely related to alterations of the microcirculation as evidenced
by increased media-to-lumen ratio of small resistance arteries and capillary rarefaction. It has been
proposed that microvasculature alterations can further deteriorate target organ damage under the influence
of increased hemodynamic load in hypertension. More than a decade ago, small artery structure
was found to be the most potent predictor of cardiovascular events in essential or secondary hypertension.
Amelioration of resistance vessel structure by antihypertensive drugs showed a clear benefit
when patients were treated with calcium antagonists and renin-angiotensin-aldosterone inhibitor regimens. Well-designed
controlled studies are needed to address the important questions whether different antihypertensive agent combinations
could be related to diverse microcirculatory “responses” in terms of structure and function.
Keywords: Hypertension, microcirculation, small arteries resistance, cardiovascular events, antihypertensive drugs.
Rights & PermissionsPrintExport