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In hypertensive, as well as in normal, subjects, it is generally held that the level of arterial blood pressure is affected largely by the tone of the terminal arterioles; the vessels beyond are only passively concerned (1 to 4). There are, nevertheless, reports to the contrary (5, 6). These studies are, for the most part, based on direct and indirect mensuration of capillary pressure. There is considerable evidence, however, that the smallest blood vessels are involved functionally and morphologically in the disorders of the peripheral vascular tree, in ways other than that which may be demonstrated by the mere determination of the pressure relationship between capillaries and arterioles (7 to 10). The experiments reported here are designed to elucidate this problem by quantification of the responses of the smallest blood vessels in the skin of a selected group of patients, by the use of two methods recently described (11, 12). The first method measures the sensitivity of small dermal blood vessels to graded mechanical stroking (vasoconstriction), while the second measures the hyperemic response consequent to a standardized period of local ischemia (vasodilation). Individual, seasonal, segmental, and aging variations of these responses in normal subjects have been previously described (11 to 13).

the journal of clinical investigation/the journal of clinical investigation

SENSITIVITY OF THE SMALLEST CUTANEOUS BLOOD VESSELS: QUANTITATIVE RESPONSES TO GRADED MECHANICAL STIMULATION AND TO LOCAL ISCHEMIA IN ARTERIAL HYPERTENSION, ARTERIOSCLEROSIS, AND CERTAIN ALLIED DISORDERS 1