Impairment of skin microvascular reactivity in hypertension and uraemia

Abstract

In hypertensive haemodialysis patients, both endothelium-dependent and -independent vasodilation was impaired. The observed increase in plasma markers of endothelial damage indicated a progression of vascular disease.

Assessment of microvascular reactivity and oxidative stress in hypertensive adolescents and hemodialysis patients

“…Even if these findings are in agreement with previous observations [52,56,[95][96][97], the mechanisms of these alterations and their possible relationship have not been fully elucidated.…”

“…The within-subject variabilities determined at fixed skin sites of healthy young subjects were 15-25% for both iontophoretic and local thermal provocations in our laboratory. In order to validate the modified LDF protocol in the clinical setting, the microvascular reactivities of 12 HD patients were assessed as the presence of an impaired microvascular function had previously been demonstrated in this group [95][96][97]. In agreement with the literature, the endothelium-dependent and -independent vasodilation both proved to be markedly diminished as compared with those in healthy young subjects (p<0.001 vs the controls; data not published) ( Table 1).…”

“…The skin microvascular reactivity, as measured by means of the laser Doppler technique, has been reported to correlate with other methods applied to assess the vascular function in distinct vascular beds, including brachial artery FMD [92,93] and transthoracic coronary echocardiography [94]. The functional impairment of the microvascular system in HD affects both the endothelium-dependent [95][96][97] and -independent vasodilations [96,97]. In contrast, only the endothelium-dependent microvascular reactivity is affected in adult hypertension, as…”

Stress repair mechanism activity explains inflammation and apoptosis

“…Its acute hyperactivation causes infarction, pulmonary embolus, thrombophlebitis, and high altitude pulmonary edema (HAPE) [189,190,195,199,[247][248][249][250][251][252][253][254][255][256][257][258][259][260][261][262][263][264][265][266]. Its chronic hyperactivation accelerates atherosclerosis and capillary senescence that causes diabetes, hypertension, and congestive heart failure [225,231,232,257,[267][268][269][270][271][272][273][274][275][276][277][278][279].…”

La physiopathologie de l’hypertension artérielle en dialyse chronique

“…La montée de la TA lors du gain de poids semble être en partie déterminée par le NO ou plutôt sa carence liée à soit une enzyme défi-ciente, soit une diminution de production de NO par anomalie de substrat due à l'existence d'analogue circulant de l'arginine (« asymetrical dimethyl arginine ») chez le dialysé. Ceci permet de mieux comprendre le rapport de Farkas et al [24]. Ces auteurs montrent une réactivité microvasculaire altérée chez des patients en dialyse chronique.…”