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Cardiovascular Research Advance Access originally published online on February 4, 2008
Cardiovascular Research 2008 78(2):274-285; doi:10.1093/cvr/cvn022
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Hypertension and microvascular remodelling

François Feihl1,*, Lucas Liaudet2, Bernard I. Levy3 and Bernard Waeber1

1 Division de Physiopathologie Clinique, Département de Médecine, Centre Hospitalier Universitaire Vaudois and Université de Lausanne, Rue du Bugnon 46, BH10-701, CH-1011 Lausanne, Switzerland
2 Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois and Université de Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland
3 Centre de Recherche Cardiovasculaire Inserm Lariboisière, U689, Hôpital Lariboisière, 41 Bd de la Chapelle, 75475 Paris, France

* Corresponding author. Tel: +41 21 314 14 23; fax: +41 21 314 14 32. E-mail address: francois.feihl{at}chuv.ch or francois.feihl{at}chuv.hospvd.ch

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.

KEYWORDS Hypertension; Microcirculation; Resistance artery; Structure

Time for primary review: 32 days


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