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(Hypertension. 2006;48:1012.)
© 2006 American Heart Association, Inc.

Brief Reviews

Hypertension

A Disease of the Microcirculation?

François Feihl; Lucas Liaudet; Bernard Waeber; Bernard I. Levy

From the Division de Physiopathologie Clinique (F.F., B.W.), Département de Médecine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Service de Médecine Intensive Adulte (L.L.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Centre de Recherche Cardiovasculaire de Lariboisière (B.I.L.), Unité Inserm 689, Hôpital Lariboisière, Paris, France.

Correspondence to François Feihl, PPA, BH10-701, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. E-mail Francois.Feihl@chuv.ch

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In the last decade, the pathophysiology of microcirculation has become an actively developing field of hypertension research, which we have felt it useful to review. An exact definition of microcirculation is elusive. It is often taken morphologically, to encompass all of the blood vessels with a diameter <150 µm, that is, some small arteries, arterioles, capillaries, and venules,¹ with the morphological distinction between small arteries and arterioles not entirely clear, because some² but not all authors³ limit the concept of arteriole to vessels containing a single layer of smooth muscle cells. Functionally, it is usually accepted that the arterial side of the microcirculation composes most of the resistance vessels, meaning that the largest part of the pressure drop between large conduit arteries and veins takes place in this segment.^2,4 The "resistance" property of small arteries and arterioles is intimately, although not exclusively, related to the prevalence of myogenic tone in these vessels.^5,6

Myogenic tone is an intrinsic property of vascular smooth muscle, which contracts in response to stretching, independent of any nerve or humoral mediation.⁵ All arteries have myogenic tone and, therefore, contract in response to an increase in blood pressure. Myogenic tone gains in importance with decreasing vessel caliber,^7,8 and only in small arteries and arterioles (diameter: 15 to 300 µm, depending on species and organ) can it provoke substantial luminal narrowing (or even closure) in reaction to an increase in transmural pressure.^8,9 In the hamster cheek pouch, for example, control of arterial/arteriolar luminal size by myogenic tone seems . . . [Full Text of this Article]

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