Effects of blood pressure control with perindopril/indapamide on the microcirculation in hypertensive patients
Abstract
BACKGROUND: Microvascular rarefaction and endothelium dysfunction are hallmarks of hypertension. We assessed whether antihypertensive treatments affect the microcirculation and whether the fixed-dose combination perindopril/indapamide (per/ind) modifies the microcirculation of hypertensive patients independently of blood pressure reduction.
METHODS: One hundred ninety-three consecutive patients were enrolled into one of four groups depending on their blood pressure and existing treatment: (i) controlled hypertensive patients treated with per/ind (controlled-per/ind), (ii) controlled hypertensive patients treated with agents other than angiotensin-converting enzyme (ACE) inhibitors or diuretics (controlled-other), (iii) uncontrolled hypertensive patients treated with agents other than ACE inhibitors or diuretics (uncontrolled-other), (iv) untreated normotensive subjects. Macro- and microcirculation parameters were evaluated once in every patient. We used intravital video microscopy to measure dermal capillary density in the dorsum of the fingers. Microvascular endothelial function was assessed by measuring the perfusion increases after pilocarpine iontophoresis and central hemodynamic parameters by tonometry.
RESULTS: Capillary density was significantly higher in controlled-per/ind patients (99 ± 12 capillaries/mm(2)) than in all other groups (P < 0.05). Controlled-per/ind patients had a significantly greater endothelial response to pilocarpine than patients from all other…
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