Limits...
Treatment of essential hypertension does not normalize capillary rarefaction.

Penna GL, Garbero Rde F, Neves MF, Oigman W, Bottino DA, Bouskela E - Clinics (Sao Paulo) (2008)

Bottom Line: Mean capillary diameters were not different at the three local points, but red blood cell velocity at baseline was significantly lower in the hypertensive group (0.98 +/- 0.05 vs. 1.17 +/- 0.04 mm/s, p<0.05).Patients treated for essential hypertension showed microvascular rarefaction, regardless of the type of therapy used.In addition, the reduced red blood cell velocity associated with capillary rarefaction might reflect the increased systemic vascular resistance, which is a hallmark of hypertension.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Objectives: To determine if capillary rarefaction persists when hypertension is treated with angiotensin converting enzyme inhibitor, thiazidic diuretic and/or beta-blocker, and to identify which microcirculatory alterations (structural and functional) persist after anti-hypertensive treatment.

Methods: We evaluated 28 well-controlled essential hypertensive patients and 19 normotensive subjects. Nailfold videocapillaroscopy examination of the fourth finger of the left hand was used to determine the functional capillary densities at baseline, during post-occlusive hyperemia, and after venous congestion. Capillary loop diameters (afferent, apical and efferent) and red blood cell velocity were also quantified.

Results: Compared with normotensive subjects, hypertensive patients showed lower mean functional capillary density at baseline (25.1 +/- 1.4 vs. 33.9 +/- 1.9 cap/mm(2), p<0.01), during post-occlusive reactive hyperemia (29.3 +/- 1.9 vs. 38.2 +/- 2.2 cap/mm(2), p<0.01) and during venous congestion responses (31.4 +/- 1.9 vs. 41.1 +/- 2.3 cap/mm(2), p<0.01). Based on the density during venous congestion, the estimated structural capillary deficit was 25.1%. Mean capillary diameters were not different at the three local points, but red blood cell velocity at baseline was significantly lower in the hypertensive group (0.98 +/- 0.05 vs. 1.17 +/- 0.04 mm/s, p<0.05).

Conclusions: Patients treated for essential hypertension showed microvascular rarefaction, regardless of the type of therapy used. In addition, the reduced red blood cell velocity associated with capillary rarefaction might reflect the increased systemic vascular resistance, which is a hallmark of hypertension.

Show MeSH

Related in: MedlinePlus

Visualization of functional capillary density before and after venous congestion, showing the increase in the number of capillaries. The results were obtained for a normotensive subject
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2664718&req=5

f1-08-0096: Visualization of functional capillary density before and after venous congestion, showing the increase in the number of capillaries. The results were obtained for a normotensive subject

Mentions: We used a miniature blood pressure cuff applied to the base of the left fourth finger inflated at 60 mmHg for 3 minutes. We visualized the capillaries for 30 seconds during the occlusion at the central field, which was previously analyzed for baseline functional capillary density. Estimated structural capillary deficit was calculated as the percentage of discrepancy of the functional capillary density between the hypertensive and normotensive subjects after the venous congestion response (Figure 1).


Treatment of essential hypertension does not normalize capillary rarefaction.

Penna GL, Garbero Rde F, Neves MF, Oigman W, Bottino DA, Bouskela E - Clinics (Sao Paulo) (2008)

Visualization of functional capillary density before and after venous congestion, showing the increase in the number of capillaries. The results were obtained for a normotensive subject
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664718&req=5

f1-08-0096: Visualization of functional capillary density before and after venous congestion, showing the increase in the number of capillaries. The results were obtained for a normotensive subject
Mentions: We used a miniature blood pressure cuff applied to the base of the left fourth finger inflated at 60 mmHg for 3 minutes. We visualized the capillaries for 30 seconds during the occlusion at the central field, which was previously analyzed for baseline functional capillary density. Estimated structural capillary deficit was calculated as the percentage of discrepancy of the functional capillary density between the hypertensive and normotensive subjects after the venous congestion response (Figure 1).

Bottom Line: Mean capillary diameters were not different at the three local points, but red blood cell velocity at baseline was significantly lower in the hypertensive group (0.98 +/- 0.05 vs. 1.17 +/- 0.04 mm/s, p<0.05).Patients treated for essential hypertension showed microvascular rarefaction, regardless of the type of therapy used.In addition, the reduced red blood cell velocity associated with capillary rarefaction might reflect the increased systemic vascular resistance, which is a hallmark of hypertension.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

ABSTRACT

Objectives: To determine if capillary rarefaction persists when hypertension is treated with angiotensin converting enzyme inhibitor, thiazidic diuretic and/or beta-blocker, and to identify which microcirculatory alterations (structural and functional) persist after anti-hypertensive treatment.

Methods: We evaluated 28 well-controlled essential hypertensive patients and 19 normotensive subjects. Nailfold videocapillaroscopy examination of the fourth finger of the left hand was used to determine the functional capillary densities at baseline, during post-occlusive hyperemia, and after venous congestion. Capillary loop diameters (afferent, apical and efferent) and red blood cell velocity were also quantified.

Results: Compared with normotensive subjects, hypertensive patients showed lower mean functional capillary density at baseline (25.1 +/- 1.4 vs. 33.9 +/- 1.9 cap/mm(2), p<0.01), during post-occlusive reactive hyperemia (29.3 +/- 1.9 vs. 38.2 +/- 2.2 cap/mm(2), p<0.01) and during venous congestion responses (31.4 +/- 1.9 vs. 41.1 +/- 2.3 cap/mm(2), p<0.01). Based on the density during venous congestion, the estimated structural capillary deficit was 25.1%. Mean capillary diameters were not different at the three local points, but red blood cell velocity at baseline was significantly lower in the hypertensive group (0.98 +/- 0.05 vs. 1.17 +/- 0.04 mm/s, p<0.05).

Conclusions: Patients treated for essential hypertension showed microvascular rarefaction, regardless of the type of therapy used. In addition, the reduced red blood cell velocity associated with capillary rarefaction might reflect the increased systemic vascular resistance, which is a hallmark of hypertension.

Show MeSH
Related in: MedlinePlus