Department of Family and Community Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
J Hypertens. 2010 Nov;28(11):2258-66. doi: 10.1097/HJH.0b013e32833e113b.
Remodeling of small resistance arteries is an early sign of target organ damage in hypertension. Peripheral capillary morphology abnormalities in hypertension are not well studied. The study objective was to determine whether altered capillary morphology is associated with SBP, DBP, or both in individuals without and with mild blood pressure elevation (SBP = 130-160 mmHg). Another objective was to determine whether capillary morphology is associated with minimum forearm vascular resistance, a measure of altered resistance artery structure.
Participants included 115 nonpregnant, nondiabetic individuals 23-55 years of age. A five-component morphology score (distribution, tone, configuration, hypertrophy, and extravasates) was developed to describe fingernail bed capillaries visualized using venous congestion in digital photomicrographs. Multiple linear regression models adjusted for age, sex, race, tobacco use, hyperglycemia, dyslipidemia, and renal function were used to analyze the relationship between SBP, DBP, and minimum forearm vascular resistance with the morphology score.
The total morphology score was significantly associated with SBP and DBP as well as minimum forearm vascular resistance (P < 0.005 for all). Among the five individual morphology score components, hypertrophy was significantly associated with SBP and DBP (P = 0.002 and 0.001, respectively), whereas extravasates were significantly associated with SBP only (P = 0.002).
A five-component capillary morphology score is associated with SBP, DBP, and altered resistance artery structure in individuals with and without mild blood pressure elevation. These observations suggest that target organ damage at the level of the microcirculation can be detected using capillary morphology.
小阻力动脉重构是高血压靶器官损害的早期标志。高血压外周毛细血管形态异常尚未得到充分研究。本研究旨在确定在血压正常升高（收缩压= 130-160mmHg）和血压轻度升高的个体中，毛细血管形态改变与收缩压、舒张压或两者是否相关。另一个目的是确定毛细血管形态是否与最小前臂血管阻力相关，最小前臂血管阻力是阻力动脉结构改变的一个指标。
参与者包括 115 名非妊娠、非糖尿病的 23-55 岁个体。采用五分制形态评分（分布、张力、构型、肥大和渗出）来描述静脉充血时数字摄影指甲床毛细血管的形态。采用多元线性回归模型，调整年龄、性别、种族、吸烟、高血糖、血脂异常和肾功能，分析收缩压、舒张压和最小前臂血管阻力与形态评分之间的关系。
总形态评分与收缩压和舒张压以及最小前臂血管阻力显著相关（所有 P < 0.005）。在五个单独的形态评分成分中，肥大与收缩压和舒张压显著相关（P = 0.002 和 0.001），而渗出仅与收缩压显著相关（P = 0.002）。
五分制毛细血管形态评分与血压升高和阻力动脉结构改变相关，包括血压正常升高和轻度升高的个体。这些观察结果表明，使用毛细血管形态可以检测到微循环水平的靶器官损害。
