ReviewIs hypertension a tissue perfusion disorder? Implications for renal and myocardial perfusionMourad, Jean-Jacquesa; Laville, Mauriceb Author Information aDepartment of Internal Medicine, Avicenne Hospital, Bobigny, France bUniversity Claude Bernard, Edouard-Herriot Hospital, Lyon, France Correspondence and requests for reprints to Professor Jean-Jacques Mourad, Hôpital Avicenne, 125 route de Stalingrad, 93009 Bobigny Cedex, France Journal of Hypertension: August 2006 - Volume 24 - Issue - p S10-S16 doi: 10.1097/01.hjh.0000240041.43214.8a Buy Metrics Abstract Structural alterations in the microcirculation form a major link between hypertension and target organ damage. More than 60% of the overall peripheral resistance of the circulatory system arises at the level of the microcirculation. The primary function of the microcirculation is to supply oxygen and nutrients to tissues. In hypertension, remodelling of the microvascular vessels occurs, leading to an early, functional then anatomical reduction in the number of arterioles or capillaries in a given vascular bed. Such changes have been seen in the structure and density of the microvasculature of different target organs such as the myocardium and the kidneys. In hypertension, capillary rarefaction induces an increase in blood pressure, a relative decrease in tissue perfusion and an increased cardiovascular risk. Recent in-vivo non-invasive techniques for exploring the human microcirculation have allowed the detection of myocardial and renal microvascular impairment in hypertensive patients. In comparative therapeutic studies, antihypertensive drugs have been shown to have different capacities for preventing or reversing changes to the microvasculature of affected organs. © 2006 Lippincott Williams & Wilkins, Inc.