Effect of pharmacological antihypertensive therapy on capillary density and microvascular endothelial function

Autor: Kaiser, Sergio Emanuel
Přispěvatelé: Tibiriçá, Eduardo Vera, Sanjuliani, Antonio Felipe, Gomes, Marilia de Brito, Nogueira, Armando da Rocha, Lessa, Marcos Adriano da Rocha, Neves, Mário Fritsch Toros
Jazyk: portugalština
Rok vydání: 2012
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da UERJ
Universidade do Estado do Rio de Janeiro (UERJ)
instacron:UERJ
Popis: Submitted by Boris Flegr (boris@uerj.br) on 2021-01-06T20:53:06Z No. of bitstreams: 1 Sergio Emanuel Kaiser.pdf: 1530841 bytes, checksum: 92e8b80b17726b318ac5e8dbff0fcc88 (MD5) Made available in DSpace on 2021-01-06T20:53:06Z (GMT). No. of bitstreams: 1 Sergio Emanuel Kaiser.pdf: 1530841 bytes, checksum: 92e8b80b17726b318ac5e8dbff0fcc88 (MD5) Previous issue date: 2012-04-17 Capillary rarefaction and microcirculatory endothelial dysfunction are hallmarks of hypertension, rendering patients vulnerable to target organ lesions. The study aimed at assessing the effect of a six-month treatment period upon capillary density and microvascular reactivity to physiological and pharmacological stimuli. In addition, two different treatment strategies were tested for possible differences between effects upon those variables. A total of 44 patients were recruited, mean age 46.7±1.3 years and 20 normotensive individuals served as controls, mean age 48.0±1.6 years. Anthropometrical and laboratory data were collected, as well as plasma levels of vascular endothelial growth factor (VEGF), its receptor Flt-1 and nitric oxide (NO). Capillary density was obtained by intra-vital microscopy of the dorsum of the middle phalanx before and after post-occlusive reactive hyperemia (PORH). Capillary loops were counted by a semi-automated software. Microvascular reactivity was tested by laser Doppler flowmetry (LDF), and the challenges consisted of acetylcholine iontophoresis, local thermal hyperemia (LTH) and PORH. Patients were randomly allocated to either one of two treatment arms: metoprolol succinate uptitrated to 100 mg daily or olmesartan medoxomil uptitrated to 40 mg daily, with addition of hydrochlorothiazide if necessary. Controls underwent the same initial protocol and all tests were repeated in patients after six months. Baseline clinical and laboratory parameters were similar between patients and controls and between the two treatment groups. After six months there were slight, although significant, differences between the two groups in waist/hip ratio and HDL-cholesterol. In the whole cohort, pretreatment capillary density was significantly reduced compared to controls (71.3±1.5 vs 80.6±1.8 cap/mm2 p
Databáze: OpenAIRE
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