Abstract-Microvascular rarefaction occurs in hypertension. We carried out a 12-week randomized double-blind crossover trial to determine the effect of a modest reduction in salt intake on capillary rarefaction in 71 whites, 69 blacks, and 29 Asians with untreated mildly raised blood pressure. Both basal and maximal (during venous congestion) skin capillary density were measured by capillaroscopy at the dorsum and the side of the fingers. In addition, we used orthogonal polarization spectral imaging to measure skin capillary density at the dorsum of the fingers and the hand web. With a reduction in salt intake from 9.7 to 6.5 g/day, there was an increase in capillary density (capillaries per millimeter squared) from 101Ϯ21 to 106Ϯ23 (basal) and 108Ϯ22 to 115Ϯ22 (maximal) at the dorsum, and 101Ϯ25 to 107Ϯ26 (basal) and 110Ϯ26 to 116Ϯ26 (maximal) at the side of the fingers (PϽ0.001 for all). Orthogonal polarization spectral imaging also showed a significant increase in capillary density both at the dorsum of the fingers and the web. Subgroup analysis showed that most of the changes were significant in all of the ethnic groups. Furthermore, there was a significant relationship between the change in 24-hour urinary sodium and the change in capillary density at the side of the fingers. These results demonstrate that a modest reduction in salt intake, as currently recommended, improves both functional and structural capillary rarefactions that occur in hypertension, and a larger reduction in salt intake would have a greater effect. The increase in capillary density may possibly carry additional beneficial effects on target organs. (Hypertension. 2010;56:253-259.)Key Words: sodium Ⅲ dietary Ⅲ microcirculation Ⅲ capillary rarefaction Ⅲ hypertension Ⅲ randomized trial M icrovascular rarefaction, that is, a reduction in the number of arterioles and capillaries, is found in many animal models of hypertension and in human hypertension. 1,2 We have shown previously that much of the reduction in capillary density in essential hypertension was because of the structural (anatomic) absence of capillaries, 2 although functional capillary rarefaction (because of nonperfusion) also existed. 1 Our previous studies also suggested that capillary rarefaction was likely to be a primary vascular abnormality. 3,4 Microvascular rarefaction increases peripheral vascular resistance, thereby increasing blood pressure (BP) and aggravating BP-related target organ damage. 1 At the same time, a reduction in the microvascular network may decrease tissue perfusion 5 and cause gradual impairments of tissues and organs. Two studies have implied that long-term effective antihypertensive treatments may reverse microvascular rarefaction in nondiabetic individuals with raised BP. 6 -8 Studies in rats demonstrated that a high-salt intake caused a significant loss of microvessels, 9,10 which occurred within a few days. 10 However, no controlled trial in humans has studied whether a modest reduction in salt intake has an effect on microcirculation.Direct in...