Microcirculation: target therapy in cardiovascular diseases - a clinical perspective.

Microcirculation conduit, distribution, exchange and reception vessels usually retain a demand-dependent vascular-tissue match as well as a nutrient friendly capillary-matrix tissue match. Various stimuli can initiate a vascular-capillary matrix-tissue mismatch. Counter-regulatory mechanisms result in hyperplasia or apoptosis. Microvascular disease (MVD) as a consequence or outcome of supply-demand mismatch has clinical therapeutic and prognostic implications in the hypertensive syndrome and coronary artery disease (CAD) cases. Recognition of the role of apoptosis and MVD may initiate a paradigm shift in clinical practice. Digitalis and other anti-hypertensive agents have anti-apoptotic action and MVD blunting effects that can control LVH development to reduce congestive heart failure (CHF) progression.