title: Structural alterations in small resistance arteries in obesity.
abstract: In cardiovascular and metabolic diseases, small resistance arteries may show the presence of structural alterations. In particular, in essential hypertension, an increased media-to-lumen ratio of subcutaneous small arteries with no change in the total amount of vascular wall tissue (eutrophic remodelling) has already been described several years ago. Similar alterations have been demonstrated also in patients with diabetes mellitus and obesity; in this case, however, a more evident contribution of vascular smooth muscle cell growth (hypertrophic remodelling) is present. This review addresses the effects of obesity on small resistance artery structure. Similar to diabetic patients, obese patients show an increased media-to-lumen ratio of subcutaneous small arteries, which appears associated with hypertrophic remodelling, as demonstrated by an increase in media cross-sectional area. Endothelial dysfunction evaluated as vasodilator response to acetylcholine has also been observed. Several studies have shown that increased media-to-lumen ratio of subcutaneous small resistance arteries possesses a prognostic significance in relation to cardiovascular outcome. Appropriate antihypertensive treatment may improve microvascular alterations both in essential hypertension and in type 2 diabetes mellitus. In obesity, a pronounced weight loss may improve microvascular structure. However, further studies are needed to elucidate the effects of other pharmacological and non-pharmacological interventions in obesity.
authors: Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. rizzoni@med.unibs.it
authors: Damiano
authors: D
authors: Rizzoni
authors: Carolina
authors: C
authors: De Ciuceis
authors: Enzo
authors: E
authors: Porteri
authors: Francesco
authors: F
authors: Semeraro
authors: Enrico Agabiti
authors: EA
authors: Rosei
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001160:Arterioles / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D055595:Mechanical Phenomena; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D009765:Obesity / Q000473:pathology* / Q000503:physiopathology*; D040521:Subcutaneous Tissue / Q000098:blood supply / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents