The influence of hypertension on microvascular blood flow and resistance to flow in the skin of patients with type 2 (non-insulin-dependent) diabetes.
Maximum microvascular blood flow and resistance to flow were determined in the skin of nine hypertensive and nine normotensive Type 2 (non-insulin-dependent) diabetic patients and nine control subjects to determine the influence of hypertension on these variables. Maximum blood flow was reduced in both the hypertensive (1.05 (0.70-1.42) V) and normotensive (1.04 (0.79-1.63) V) Type 2 diabetic patients when compared with control subjects (1.40 (1.26-2.13) V, p < 0.01 for hypertensive and p < 0.05 for normotensive patients, respectively); however, maximum blood flow was similar in both groups of diabetic patients (p = 0.82). In contrast, resistance to flow was significantly greater in the diabetic patients with hypertension (127.2 (87.5-181.3) mmHg V-1 vs 84.7 (61.9-123.0) mmHg V-1 normotensive diabetic patients, p < 0.02). In addition, R was greater in the normotensive Type 2 diabetic patients than in control subjects (70.7 (44.7-79.9) mmHg V-1, p < 0.05). These results suggest that hypertension is associated with an additional rise in pre-capillary vascular resistance in Type 2 diabetes which, while protecting the microcirculation from the effects of increased arterial pressure, may further diminish protective hyperaemic responses.
Jaap
A J
AJ
Department of Vascular Medicine, Postgraduate Medical School, University of Exeter, UK.
Shore
A C
AC
Tooke
J E
JE
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012867:Skin / Q000098:blood supply*; D014655:Vascular Resistance / Q000502:physiology*