Impaired microcirculation in mild-to-moderate essential arterial hypertension

Duprez, Daniel; Buyzere, Marc De; Backer, Tine De; Vercammen, Jan; Brusselmans, F.; Clément, Denis

doi:10.1097/00004872-199203000-00008

Cited by 28 publications

(10 citation statements)

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“…However, when patients using vaso-active medication were excluded in the analyses, the same results were obtained. The effect of hypertension on skin microcirculation is still a matter of debate, but some authors observed a reduction in capillary density and CBV in non-diabetic patients compared with healthy control subjects [37,38,39]. However, our groups (in particular the diabetic patients) were well matched for blood pressure and the severity of polyneuropathy was in these patients independently associated with a reduction of CBV.…”

Section: Discussionmentioning

confidence: 64%

The effect of polyneuropathy on foot microcirculation in Type II diabetes

Nabuurs-Franssen

Houben

Tooke³

et al. 2002

Diabetologia

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Aims/hypothesis. The aim of this study was to investigate the influence of peripheral polyneuropathy (PNP) on skin microcirculation and foot swelling rate in the feet of patients with Type II (non-insulin-dependent) diabetes mellitus. Methods. 38 Type II diabetic patients, 24 with PNP (PNP+), 14 without PNP (PNP-), and 16 healthy control subjects were studied, first supine and subsequently sitting with the foot dependent for 50 mn.Results. In patients with PNP, foot skin temperature was higher, (p<0.04) and capillary blood cell velocity (CBV, nailfold capillary microscopy), was lower compared to patients without PNP (222 vs 313 µm/s respectively, p<0.03). Compared to the control subjects, the percentage reduction in skin blood flux, (LDF, laser-Doppler fluxmetry), after 10 min was higher in the PNP-and PNP+ patients (3% vs 18% and 26% respectively, p<0.02). These disturbances were most pronounced in PNP+ patients with a history of a foot ulcer. Foot swelling rate (mercury strain gauge plethysmography) in the first 10 min of dependency, was lower in patients with PNP+ compared to the control subjects (0.00165 vs 0.00286 ml·100 ml -1 s respectively, p<0.01). In addition, we found a negative correlation (r=-0.41; p<0.01) between Valk-score (severity of PNP) and FSR. Conclusion/interpretation. Type II diabetes PNP is associated with multiple abnormalities in the (skin) microcirculation of the foot, characterised by reduced capillary blood flow, an enhanced reduction in skin blood flux and impaired fluid filtration after sitting up. The most severe abnormalities were observed in patients with a history of foot ulceration. [Diabetologia (2002[Diabetologia ( ) 45:1164[Diabetologia ( -1172

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Section: Discussionmentioning

confidence: 64%

The effect of polyneuropathy on foot microcirculation in Type II diabetes

Nabuurs-Franssen

Houben

Tooke³

et al. 2002

Diabetologia

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“…Structural abnormalities in vessels of hypertensive patients include decreased luminal diameter, predominantly in larger arterioles (5,6), but also in capillaries (7,8), and a reduction in the density of vessels per volume of tissue (known as rarefaction), which occurs predominantly in the smallest vessels (2,(7)(8)(9)(10)(11)(12)(13). Functional abnormalities of microvessels in established essential hypertension include reduced capillary blood flow in the basal state (14) and reduced vasodilatation induced by heating (15). The latter may be a functional consequence of abnormal structure since increased resistance in vessels which are maximally dilated is the hallmark of structural change (5,16).…”

Section: Introductionmentioning

confidence: 99%

Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.

Noon¹,

Walker²,

Webb³

et al. 1997

J. Clin. Invest.

299

186

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“…Hypertensive alterations of peripheral capillaries 3,4,6 and the response of finger nailfold capillaroscopic findings to anti-hypertensive drug treatment 14 have rarely been investigated. This is the first report on the effects of an angiotensin-II blocker and a calcium channel blocker on peripheral capillary microcirculation in patients with mild-to-moderate hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Moreover, finger microcirculation deteriorates as a function of the severity and duration of chronic heart failure, a common condition observed in end-stage hypertensive heart disease with activated sympathoadrenal tone. 5 Structural changes and reduced density of capilCorrespondence: Dr B Martina, Medical Outpatient Clinic, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland Received 28 November 1997; revised and accepted 18 March 1998 (n = 10) and losartan titrated to losartan-HCT (n = 10) sitting BP decreased significantly from 160 ± 7/103 ± 4 mm Hg and 147 ± 7/98 ± 6 mm Hg to 131 ± 10/86 ± 7 mm Hg and 134 ± 17/89 ± 9 mm Hg, respectively (P Ͻ 0.01).…”

Section: Introductionmentioning

confidence: 99%

Effects of losartan titrated to losartan/hydrochlorothiazide and amlodipine on blood pressure and peripheral capillary microcirculation in patients with mild-to-moderate hypertension

et al. 1998

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Objective: To measure the effects of losartan and amlodipine on peripheral capillary microcirculation in hypertension. Setting: Medical out-patient clinic, Basel, in a university teaching hospital. Methods: After a 4-week placebo run-in period 20 patients aged 50 ± 8 (range 36-65) years with mild-tomoderate hypertension were randomly allocated to receive active treatment with losartan 50 mg titrated to losartan 50 mg/hydrochlorothiazide (HCT) 12.5 mg, or amlodipine 5 mg titrated to 10 mg for a 12 week period. Titration was performed if diastolic blood pressure (BP) was у90 mm Hg after 6 weeks of treatment. BP measurements as well as video capillary microscopy of the finger nailfold at the end of the placebo period and after 12 weeks of active treatment were compared. Capillary blood cell velocity was measured at rest and immediately, 1 min and 2 min after local finger cooling. Results: After 3 months of treatment with amlodipine

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Impaired microcirculation in mild-to-moderate essential arterial hypertension

Cited by 28 publications

References 0 publications

The effect of polyneuropathy on foot microcirculation in Type II diabetes

The effect of polyneuropathy on foot microcirculation in Type II diabetes

Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.

Effects of losartan titrated to losartan/hydrochlorothiazide and amlodipine on blood pressure and peripheral capillary microcirculation in patients with mild-to-moderate hypertension

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