The aim of the study was to assess the reactivity of the cutaneous microcirculation in patients with arterial hypertension (AH), taking into account the intake of anti-hypertensive drugs, using laser doppler flowometry (LDF) and the post-occlusive reactive hyperaemia (PORH) test.

Material and methods:
The analysis included 44 patients with well-controlled AH, and 22 subjectively healthy volunteers aged 23 – 74 years, matched with the study group. During the study period, 22 patients in the study group were taking ACEI drugs, also in combination with other drug groups in terms of gender and age. 19 patients were taking other groups of drugs, including: ARB, beta-blockers, alpha-blockers, CCB, diuretics, also in combination, while 3 patients were not taking medication for AH; they were recommended non-pharmacological treatment. Blood biochemical tests, ambulatory blood pressure monitoring (ABPM) and PORH test using LDF were performed.

The study showed that the PORH flow parameters were not differ statistically significantly between the study and control groups (p> 0.05). Statistically significant differences were shown in the PORH maximum level (ML) on the skin forearm between the study group not taking ACEI drugs and the control group. No statistically significant differences were shown between the study group taking ACEI and the control group.

The pathogenesis of AH is multifactorial and depends, inter alia, on disturbances at the level of microcirculation. Proper treatment, especially with the use of ACEI, can improve the microcirculation in AH patients

Williams B, Mancia G, Spiering W. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021–3104.
Oparil S, Acelajado MC, Bakris GL. Hypertension. Nat Rev Dis Primers. 2018 Mar 22;4:18014.
De Ciuceis C, Salvetti M, Rossini C. Effect of antihypertensive treatment on microvascular structure, central blood pressure and oxidative stress in patients with mild essential hypertension. J Hypertens. 2014 Mar;32(3):565–74.
Ghiadoni L, Taddei S, Virdis A. Hypertension and endothelial dysfunction: therapeutic approach. Curr Vasc Pharmacol. 2012 Jan;10(1):42–60.
Goto K, Ohtsubo T, Kitazono T. Endothelium-Dependent Hyperpolarization (EDH) in Hypertension: The Role of Endothelial Ion Channels. Int J Mol Sci. 2018 Jan; 19(1): 315. Published online 2018 Jan 21.
Cracowski JL, Roustit M. Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser-Based-Techniques. Microcirculation. 2016 Jul;23(5):337–44.
Gryglewska B, Głuszewska A, Zarzycki B. Post-occlusive reactive hyperemic response of skin microcirculation among extremely obese patients in the short and long term after bariatric surgery. Microcirculation. 2019 Nov 28:e12600.
Rossi M, Bradbury A, Magagna A. Investigation of skin vasoreactivity and blood flow oscillations in hypertensive patients: effect of short-term antihypertensive treatment. J Hypertens. 2011 Aug;29(8):1569–76.
Singh JN, Nguyen T, Kerndt CC. Physiology, Blood Pressure Age Related Changes. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan.
Jung F, Pindur G, Ohlmann P. Microcirculation in hypertensive patients. Biorheology. 2013;50(5–6):241–55.
Zegarra-Parodi R, Snider EJ, Park PY. Laser Doppler flowmetry in manual medicine research. J Am Osteopath Assoc. 2014 Dec;114(12):908–17.
Iredahl F, Löfberg A, Sjöberg F. Non-Invasive Measurement of Skin Microvascular Response during Pharmacological and Physiological Provocations. PLoS One. 2015;10(8):e0133760.
Shirazi BR, Valentine RJ, Lang JA. Reproducibility and normalization of reactive hyperemia using laser speckle contrast imaging. PLoS One. 2021 Jan 7;16(1):e0244795.
Melik Z, Princi T, Grill V. The effect of caffeine on cutaneous postocclusive reactive hyperaemia. PLoS One. 2019;14(4):e0214919. Published 2019 Apr 8.
Moens AL, Goovaerts I, Claeys MJ. Flow-mediated vasodilation: a diagnostic instrument, or an experimental tool? Chest. 2005 Jun;127(6):2254–63.
Yvonne-Tee GB, Rasool AH, Halim AS. Reproducibility of different laser Doppler fluximetry parameters of postocclusive reactive hyperemia in human forearm skin. J Pharmacol Toxicol Methods. 2005 Sep-Oct;52(2):286–92. Epub 2005 Jan 11.
Pena-Hernandez C, Nugent K, Tuncel M. Twenty-Four-Hour Ambulatory Blood Pressure Monitoring. J Prim Care Community Health. 2020;11:2150132720940519.
Farkas K, Kolossváry E, Járai Z. Non-invasive assessment of microvascular endothelial function by laser Doppler flowmetry in patients with essential hypertension. Atherosclerosis. 2004 Mar;173(1):97–102.
Sieg-Dobrescu D, Burnier M, Hayoz D. The return of increased blood pressure after discontinuation of antihypertensive treatment is associated with an impaired post-ischemic skin blood flow response. J Hypertens. 2001 Aug;19(8):1387–92.
Higashi Y, Sasaki S, Nakagawa K. A comparison of angiotensin-converting enzyme inhibitors, calcium antagonists, beta-blockers and diuretic agents on reactive hyperemia in patients with essential hypertension: a multicenter study. J Am Coll Cardiol. 2000 Feb;35(2):284–91.
Ghiadoni L, Magagna A, Versari D. Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension. 2003Jun;41(6):1281–6.
Korolev AI, Fedorovich AA. Parameters of cutaneous microvasculature in men of working age with newly diagnosed arterial hypertension. Clin Hemorheol Microcirc. 2022;80(4):373–387.
Gkaliagkousi E, Lazaridis A, Anyfanti P. Assessment of skin microcirculation in primary aldosteronism: impaired microvascular responses compared to essential hypertensives and normotensives. J Hum Hypertens. 2021 Nov 20.
Binggeli C, Spieker LE, Corti R. Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients: a monitoring test of endothelial dysfunction for clinical practice? J Am Coll Cardiol. 2003 Jul 2;42(1):71–7.
Tousoulis D, Antoniades C, Bosinakou E. Effects of atorvastatin on reactive hyperaemia and the thrombosis-fibrinolysis system in patients with heart failure. Heart. 2005 Jan;91(1):27–31.
Gerage AM, Benedetti TRB, Cavalcante BR. Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (Sao Paulo). 2020;18:eAO5227.Published,2020,Jan,31.
Guerrero-García C, Rubio-Guerra A. Combination therapy in the treatment of hypertension. Drugs Context. 2018; 7: 212531. 338 Published online 2018 Jun 6.