Increased skin capillary density in treated essential hypertensive patients
Increased skin capillary density in treated essential hypertensive patients
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DOI：
10.1016/j.amjhyper.2005.10.021
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发表时间：
2006-05-01
影响因子：
3.2
通讯作者：
Tibiriçà, E
中科院分区：
文献类型：
--
作者：
Debbabi, H;Uzan, L;Tibiriçà, E
背景：微血管稀疏是原发性高血压的标志。我们测量了接受有效降压治疗的非糖尿病高血压受试者的皮肤毛细血管密度，并评估了其与动脉血压（BP）的可能相关性。这项横断面观察性研究包括76名（55 +/- 1年）连续门诊接受慢性降压药物治疗的原发性高血压患者血压< 140/90 mm Hg），24例年龄和性别匹配的新近发现且从未治疗过的高血压患者和70例血压正常（血压< 140/90 mm Hg）年龄和性别匹配的健康对照者。我们使用活体视频显微镜来测量手指背的基础和最大（静脉充血期间）皮肤毛细血管密度。通过桡动脉压平张力计计算脉搏波速度和中心主动脉压来评估主动脉僵硬度。（数量/mm（2））显著低于未经治疗的高血压患者比经治疗的高血压患者（59.6 +/- 2.0和62.0 +/- 1.9）（74.0 +/- 1.4和79.4 +/- 1.5; P < .001），而血压正常者（68.2 +/- 1.5和72.4 +/- 1.5; P < .001）。基于多元回归分析，调整烟草消费后，血压正常者的主动脉（而不是肱动脉）收缩压与基础和闭塞后毛细血管密度呈负相关。在高血压患者中，这种相关性消失，毛细血管密度的影响，两个独立的变量，抗高血压药物治疗和overweight.Conclusions：在非糖尿病高血压患者中，毛细血管密度降低与一组心血管危险因素，涉及烟草消费和肥胖。在有效治疗和高血压患者中毛细血管密度增加的发现表明，应在长期前瞻性随访中评估BP和毛细血管密度之间的因果关系。
Background: Microvascular rarefaction is a hallmark of essential hypertension. We measured the skin capillary density in nondiabetic hypertensive subjects with effective antihypertensive treatment and evaluated possible correlations with arterial blood pressure (BP).Methods: This cross-sectional observational study included 76 (55 +/- 1 years) consecutive outpatients with essential hypertension under chronic antihypertensive drug treatment (BP < 140/90 mm Hg), 24 age- and sex-matched patients with recently discovered and never-treated hypertension and 70 normotensive (BP < 140/90 mm Hg) age- and sex-matched healthy controls. We used intravital video-microscopy to measure basal and maximal (during venous congestion) skin capillary densities in the dorsum of the fingers. Aortic stiffness was evaluated using pulse wave velocity and central aortic pressure calculated from radial artery applanation tonometry.Results: Baseline and maximal capillary densities (number/mm(2)) were significantly lower (59.6 +/- 2.0 and 62.0 +/- 1.9) in untreated than in treated hypertensive patients (74.0 +/- 1.4 and 79.4 +/- 1.5; P < .001) and than in normotensives (68.2 +/- 1.5 and 72.4 +/- 1.5; P < .001). Based on multiple regression analysis, after adjustment to tobacco consumption, aortic (and not brachial) systolic BP was inversely correlated with basal and postocclusive capillary densities in normotensive subjects. In hypertensives, this correlation disappears and capillary density was influenced by two independent variables, antihypertensive drug treatment and overweight.Conclusions: In nondiabetic hypertensive patients, capillary density is reduced in association with a cluster of cardiovascular risk factors involving tobacco consumption and obesity. The finding of an increased capillary density in effectively treated and hypertensives suggests that a cause-to-effect relationship between BP and capillary density should be evaluated in a long-term prospective follow-up.