Clinical and Experimental Research Laboratory on Vascular Biology (Biovasc) - State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Pedro Ernesto University Hospital - Medical School - State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Hypertens Res. 2018 Jul;41(7):515-523. doi: 10.1038/s41440-018-0043-3. Epub 2018 Apr 23.
Microcirculation influences peripheral vascular resistance and therefore contributes to arterial blood pressure. The aim of this study was to investigate the correlation between serum markers of inflammation and microcirculatory parameters observed by nailfold videocapillaroscopy (NVC) in patients with resistant (RH, 58 [50-63] years, n = 25) or mild-to-moderate hypertension (MMH, 56 [47-64] years, n = 25) compared to normotensive patients (control group (CG), 33 [27-52] years, n = 25). C-reactive protein (CRP), endothelin, adiponectin, I-CAM and V-CAM levels were obtained by laboratory analysis. Functional capillary density (FCD; the number of capillaries with flowing red blood cells by unit tissue area), capillary diameters, maximum red blood cell velocity (RBCV) during the reactive hyperemia response/RBCV after 1 min of arterial occlusion at the finger base and time to reach RBCV were determined by NVC. A sub-analysis was also conducted on hypertensive patients not taking statins, with controlled/uncontrolled blood pressure. The RH group showed lower RBCV and RBCV values and longer TRBCV compared to MMH and CG patients, with worse values in those with uncontrolled blood pressure. FCD and diameters showed no significant differences among the three groups, with higher CRP values in the RH and MMH groups. An increase in endothelin was observed only in patients not taking statins in both hypertensive groups. Patients with severe hypertension and uncontrolled blood pressure levels presented more pronounced microvascular dysfunction, as well as higher serum values for CRP and endothelin (without statin treatment), suggesting that the use of statins decreases endothelin release.
微循环影响外周血管阻力，从而影响动脉血压。本研究旨在探讨炎症血清标志物与甲襞微循环参数的相关性，研究对象为耐治疗性高血压（RH，58 [50-63] 岁，n = 25）和轻中度高血压（MMH，56 [47-64] 岁，n = 25）患者与正常血压患者（对照组（CG），33 [27-52] 岁，n = 25）。通过实验室分析获得 C 反应蛋白（CRP）、内皮素、脂联素、细胞间黏附分子（I-CAM）和血管细胞黏附分子（V-CAM）水平。通过甲襞微循环检查（NVC）确定功能毛细血管密度（FCD；单位组织面积内有流动红细胞的毛细血管数量）、毛细血管直径、手指底部动脉闭塞后反应性充血期间的最大红细胞速度（RBCV）/动脉闭塞后 1 分钟的 RBCV 以及达到 RBCV 的时间。还对未服用他汀类药物、血压控制/未控制的高血压患者进行了亚分析。与 MMH 和 CG 患者相比，RH 组 RBCV 和 RBCV 值较低，TRBCV 较长，且血压未控制的患者值更差。三组之间 FCD 和直径无显著差异，RH 和 MMH 组 CRP 值较高。仅在高血压组中未服用他汀类药物的患者中观察到内皮素增加。严重高血压和血压控制不佳的患者表现出更明显的微血管功能障碍，以及更高的 CRP 和内皮素血清值（未进行他汀类药物治疗），这表明他汀类药物的使用可降低内皮素的释放。
