Microvascular remodelling of subcutaneous resistance arteries acts as an independent predictor of cardiovascular risk in hypertensive patients and may contribute to end-organ damage.
This review highlights that microvascular remodelling in hypertension is not only a structural adaptation but also an independent predictor of cardiovascular risk and a potential target for antihypertensive therapy.
In the present review, microvascular remodelling refers to alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension. We start with some historical aspects, underscoring the importance of Folkow's contribution made half a century ago. We then move to some basic concepts on the biomechanics of blood vessels, and explicit the definitions proposed by Mulvany for specific forms of remodelling, especially inward eutrophic and inward hypertrophic. The available evidence for the existence of remodelled resistance vessels in hypertension comes next, with relatively more weight given to human, in comparison with animal data. Mechanisms are discussed. The impact of antihypertensive drug treatment on remodelling is described, again with emphasis on human data. Some details are given on the three studies to date which point to remodelling of subcutaneous resistance arteries as an independent predictor of cardiovascular risk in hypertensive patients. We terminate by considering the potential role of remodelling in the pathogenesis of end-organ damage and in the perpetuation of hypertension.
Feihl et al. (Mon,) conducted a review in Hypertension. Microvascular remodelling was evaluated. Microvascular remodelling of subcutaneous resistance arteries acts as an independent predictor of cardiovascular risk in hypertensive patients and may contribute to end-organ damage.
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