State of microcirculation and microalbuminuria in patients with arterial hypertension


B.Z. Sirotin, K.V. Zhmerenetskii, E.V. Zhmerenetskaya

Purpose. The assessment of state of microcirculation (MC) in patients with arterial hypertension (AH) and microalbuminuria (MAU) in comparison with the nature of the MC in AH without MAU. Material and methods. The examination of MC was performed by digital videobiomicroscopy of vessels of bulbar conjunctiva in 21 patients with II-III degree AH and MAU in comparison with the state of the microvasculature in 24 patients with II-III degree AH without MAU. Results. Systemic failure of microvasculature with the development of moderate (in 33.3% of cases) or severe (in 23.8%) MC deficiency with reduced microvascular reserve is observed in AH with MAU. Morphometric data for microvasculature indicate a tendency to spastic states of arterioles with reactive restructuring of venules (53.50 ± 2.94 versus 46.50 ± 2.80; p <0.05), and progressive decrease in exchange surface of the capillary net with the reduction of nutritive blood flow (0.23 ± 0.02 versus 0.33 ± 0.047; p<0,01) in the presence of MAU. Correlation between the average caliber of arterioles and specific density of capillaries in AH and the degree of MAU (0.39 ± 0.016; p <0.05 and 0.41 ± 0,016; p <0.05) is revealed. Conclusion. Comparison of data for noninvasive imaging of microvasculature reveals signs of the appearance of MAU in patients with arterial hypertension. It is recommended to include digital videobiomicroscopy of vessels of bulbar conjunctiva in the survey protocol of the patients with AH for detection of severity of MAU.

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