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(Hypertension. 2007;50:603.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Vascular Remodeling, Retinal Arteries, and Hypertension

Rhian M. Touyz

From the Kidney Research Centre, University of Ottawa, Ottawa Health Research Institute, Ottawa, Ontario, Canada.

Correspondence to Rhian M. Touyz, Kidney Research Centre, Ottawa Health Research Institute, University of Ottawa, Room 2513/451, Smyth Rd, Ottawa, Ontario K1H 8M5, Canada. E-mail rtouyz@uottawa.ca

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

Remodeling of the vasculature is an active process of structural changes that involves alterations in cellular processes, including growth, apoptosis, migration, inflammation, and production of extracellular matrix proteins, resulting in an increase in the media:lumen ratio.^1,2 Physiological remodeling is an adaptive response occurring in response to hemodynamic changes and ageing. However, when this process becomes maladaptive, it plays a role in the pathophysiology of hypertension and its complications. Increased media:lumen ratio in small resistance arteries, because of an increase in muscle mass or rearrangements of cellular and noncellular elements, increases vascular resistance to blood flow contributing to elevated blood pressure.¹ These structural changes may augment vascular reactivity, which potentiates the increase in the peripheral resistance characteristic of hypertension. Convincing evidence from studies examining small arteries obtained from gluteal biopsies of patients with hypertension indicates that vascular remodeling is a characteristic feature in hypertension, that it is one of the first manifestations of target organ damage occurring before proteinuria or cardiac hypertrophy, and that it is a dynamic process that is reversible.^3,4 Of clinical importance, the magnitude of remodeling of small arteries has prognostic significance over a 10-year period, with worse prognosis for subjects with hypertension with greater remodeling.⁵

In most studies, small arteries from humans have been studied using isolated microvessels from gluteal subcutaneous tissues. Although this approach has advantages in that it allows for direct assessment of structural and functional characteristics of resistance arteries from well-characterized patients and healthy individuals, the procedure is invasive, requiring surgical incision and sutures. . . . [Full Text of this Article]

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