Title:Early Functional and Structural Microvascular Changes in Hypertension Related to Aging
Volume: 13
Issue: 1
Author(s): Roger de Moraes and Eduardo Tibirica*
Affiliation:
- Laboratory of Cardiovascular Investigation - Oswaldo Cruz Institute, Av. Brasil, 4365, 21045-900, Rio de Janeiro,Brazil
Keywords:
Hypertension, microcirculation, microvascular rarefaction, endothelial function, aging.
Abstract: It is becoming increasingly clear that both microvascular network alterations and subsequent
tissue perfusion defects may precede and predict the development of arterial hypertension and
other cardiovascular and metabolic diseases, including diabetes and metabolic syndrome. Moreover,
the subsequent functional and structural alterations in microvascular reactivity and density, as well
as alterations in the macrocirculation characteristic of physiologic vascular aging, contribute to the
development of target organ damage. Microvascular rarefaction appears to be an early vascular
structural alteration in the setting of hypertension, as it is already present in individuals presenting
with borderline hypertension and normotensive young adults with a familial predisposition to high
blood pressure. The chronic increases in blood pressure that occur during senescence secondary to
macrocirculatory changes induce vasoconstriction within the microcirculation, which promotes the
development of tissue hypoxia and reduces both arteriolar and capillary density. This phenomenon
contributes to additional increases in peripheral vascular resistance and establishes a vicious cycle
that culminates in both tissue injury and target organ damage, which are equally present in senescence
and hypertension. Therefore, the microcirculation may be considered an essential target for
both the pharmacological and non-pharmacological treatment of arterial hypertension and other
cardiovascular diseases.
