Cardiovascular Research Advance Access first published online on February 4, 2008
This version [Accepted Manuscript] published online on March 4, 2008
Cardiovascular Research, doi:10.1093/cvr/cvn022
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Hypertension and microvascular remodelling
1 Division de Physiopathologie Clinique, Département de Médecine
2 Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois and University of 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
Address for correspondence François Feihl, MD Associate Professor PPA, BH10-701 CHUV 1011 Lausanne Switzerland Phone 0041 21 314 14 23 Fax 0041 21 314 14 32 e-mail Francois.Feihl{at}chuv.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
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