Methods for the assessment of microcirculation in patients with hypertension

Abstract

Background: Skin microcirculation is considered an easily accessible vascular bed, which can potentially be representative and helpful in evaluating, understanding the mechanisms of microvascular function and detection of its dysfunction. Many studies claim that functional changes in cutaneous circulation precede the development of arterial hypertension (HT). Identifying them at an early stage can enhance patients’ prognosis. There are methods which can be applied for these purposes. We aimed to describe available methods of skin microcirculation assessment, in the context of HT. Material and methods: The PubMed database was searched till March 2022. Research articles used in the systematic review were experimental articles, reviews and abstracts from conference materials that reported the methods of the microcirculation assessment. From 1131 records, 47 articles were included in the final review. Results: This review identified that the microcirculation examined with various methods was dysfunctional in HT patients. Standard HT treatment usually helped to achieve a partial reversal of those changes. Even though some of the methods described are non-invasive and relatively affordable, still, none of them is the standard for HT diagnosis. Conclusion: Each of the methods has its advantages and disadvantages. Photoplethysmography appears to be promising. The method is non-invasive, cheap, does not require experience, and might be synchronized with mobile devices. It is possible that the simplification of the device calibration process and the development of a method allowing for the correct interpretation of the result, regardless of e.g., the patient's skin color, could influence its wider use in the group of HT patients.