Structural Alterations of Subcutaneous Small-Resistance Arteries May Predict Major Cardiovascular Events in Patients With Hypertension

Carolina De Ciuceis, Enzo Porteri, Damiano Rizzoni, Nicola Rizzardi, Silvia Paiardi, Gianluca E M Boari, Marco Miclini, Francesca Zani, Maria Lorenza Muiesan, Francesco Donato, Massimo Salvetti, Maurizio Castellano, Guido A M Tiberio, Stefano M. Giulini, Enrico Agabiti Rosei

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Structural alterations in the microcirculation may be considered an important mechanism of organ damage. An increased tunica media to internal lumen ratio of subcutaneous small-resistance arteries (M:L) may predict the development of cardiovascular events in a high-risk population. However, it is not known whether structural alterations of small arteries may also predict major cardiovascular events. Methods: Three hundred three subjects were included in the present study. There were 65 normotensive subjects, 111 patients with essential hypertension (33% of them with diabetes mellitus), 109 patients with secondary forms of hypertension, and 18 normotensive diabetic patients. Small-resistance arteries were dissected from subcutaneous fat biopsies and mounted on an isometric myograph, and the M:L was measured. Subjects were reevaluated after an average follow-up time of 6.9 years to assess the occurrence of cardio-cerebrovascular events. Results: Eleven subjects died of a fatal cardio-cerebrovascular event (FCE), 14 had a major, nonfatal cardiovascular event (stroke or myocardial infarction) (SMI), 23 had a minor cardiovascular event (MCE), and 255 had no cardiovascular event (NCE). A significant difference was observed in M:L and in event-free survival between patients with FCEs + SMIs + MCEs and those with NCE and between patients with FCEs + SMIs and those with NCE. Similar results were obtained by restricting the analysis to patients with essential hypertension. Conclusions: Structural alterations of small-resistance arteries may predict FCE and SMI. The prognostic role of small-resistance artery structure also applies to medium-risk patients with essential hypertension, at least when MCEs are included in the analysis.

Original languageEnglish
Pages (from-to)846-852
Number of pages7
JournalAmerican Journal of Hypertension
Volume20
Issue number8
DOIs
Publication statusPublished - Aug 2007

Keywords

  • arteries
  • hypertension
  • hypertrophy
  • prognosis
  • remodeling
  • Vessels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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