Tsioufis Costas, Dimitriadis Kyriakos, Katsiki Niki, Tousoulis Dimitris
Vasilisis Sofias 114, 11527 Athens, Greece.
Curr Vasc Pharmacol. 2015;13(3):413-7. doi: 10.2174/1570161113666150206110512.
Essential hypertension is closely related to alterations of the microcirculation as evidenced by increased media-to-lumen ratio of small resistance arteries and capillary rarefaction. It has been proposed that microvasculature alterations can further deteriorate target organ damage under the influence of increased hemodynamic load in hypertension. More than a decade ago, small artery structure was found to be the most potent predictor of cardiovascular events in essential or secondary hypertension. Amelioration of resistance vessel structure by antihypertensive drugs showed a clear benefit when patients were treated with calcium antagonists and renin-angiotensin-aldosterone inhibitor regimens. Well-designed controlled studies are needed to address the important questions whether different antihypertensive agent combinations could be related to diverse microcirculatory "responses" in terms of structure and function.
原发性高血压与微循环改变密切相关，小阻力动脉的中膜与管腔比值增加和毛细血管稀疏就是证据。有人提出，在高血压血流动力学负荷增加的影响下，微血管改变会进一步加重靶器官损害。十多年前，人们发现小动脉结构是原发性或继发性高血压中心血管事件最有力的预测指标。当患者接受钙拮抗剂和肾素-血管紧张素-醛固酮抑制剂治疗方案时，降压药物对阻力血管结构的改善显示出明显的益处。需要精心设计的对照研究来解决重要问题，即不同的降压药物组合在结构和功能方面是否可能与不同的微循环“反应”相关。
