Abstract：
Although the gold-standard method for the assessment of structural alteration in small resistance arteries is the evaluation of the MLR by micromyography in bioptic tissues, new, noninvasive techniques are presently under development, focusing mainly on the evaluation of WLR in retinal arterioles. These approaches represent a promising and interesting future perspective. Appropriate antihypertensive treatment is able to prevent the development of microvascular alterations or to induce their regression. Also, conductance arteries may be affected by a remodeling process in hypertension, and a cross-talk may exist between structural changes in the small and large arteries. In conclusion, the evaluation of microvascular structure is ready for clinical prime time, and it could, in the future, represent an evaluation to be performed in the majority of hypertensive patients, to better stratify cardiovascular risk and better evaluate the effects of antihypertensive therapy. However, for this purpose, we need a clear demonstration of the prognostic relevance of noninvasive measures of microvascular structure, in basal conditions and during treatment. Vascular remodeling may be frequently observed in hypertension, as well as in obesity and diabetes mellitus. An increased media to lumen ratio (MLR) or wall to lumen ratio (WLR) in microvessels is the hallmark of hypertension, and may impair organ flow reserve, being relevant in the maintenance and, probably, also in the progressive worsening of hypertensive disease, as well as in the development of hypertension-mediated organ damage/cardiovascular events. The molecular mechanisms underlying the development of vascular remodeling are only partly understood.
摘要：
尽管评估小阻力动脉结构改变的金标准方法是通过活检组织的显微肌电图评估MLR，新,非侵入性技术目前正在开发中，主要对视网膜小动脉WLR的评价。这些方法代表了一个有希望和有趣的未来前景。适当的抗高血压治疗能够防止微血管改变的发展或诱导其消退。此外，传导动脉可能会受到高血压重塑过程的影响，小动脉和大动脉的结构变化之间可能存在串扰。总之,微血管结构的评估为临床黄金时段做好了准备，它可以，在未来,代表对大多数高血压患者进行的评估，以更好地对心血管风险进行分层并更好地评估降压治疗的效果。然而,为此,我们需要清楚地证明微血管结构的非侵入性措施的预后相关性，在基础条件和治疗期间。在高血压中经常观察到血管重塑，以及肥胖和糖尿病。微血管中的介质与管腔比率（MLR）或壁与管腔比率（WLR）增加是高血压的标志，并可能损害器官血流储备，与维护相关，可能,在高血压疾病的进行性恶化中，以及高血压介导的器官损伤/心血管事件的发展。血管重塑发展的分子机制仅得到部分理解。
