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Background/Objectives: Skin microcirculation represents an easily accessible window reflecting generalized microvascular dysfunction. It has been correlated with alterations in several microvascular beds, though evidence regarding its association with macrovascular damage is scarce. Carotid artery stiffening is a surrogate marker of macrovascular damage that has been significantly associated with incident stroke and cardiovascular mortality. In this study, we investigated the association between skin microcirculation and carotid stiffness in a mixed population of hypertensive and normotensive individuals. Methods: Untreated newly-hypertensive and normotensive individuals without major cardiovascular comorbidities were included in the study. Blood pressure (BP) parameters were recorded with the Mobil-O-Graph NG (IEM, Stolberg, Germany) device. Carotid measurements were performed using a high-resolution echo-tracking system (Prosound Alpha 7, Aloka, Japan). The beta index (β) was automatically calculated and averaged for the right and left common carotid artery values. Skin microcirculation was assessed under standardized conditions using laser speckle contrast analysis (PeriCam PSI NR, Perimed, Sweden) in conjunction with post-occlusive reactive hyperemia protocol. Results are expressed as a percentage increase between baseline and peak perfusion (%). Results: We studied 101 individuals including 70 newly diagnosed, untreated essential hypertensives aged 49.6 ± 9.4 and 31 healthy normotensive individuals. The β index demonstrated a significant negative correlation with the percentage increase between baseline and peak skin microvascular perfusion (r = −0.251, p = 0.01). Conclusion: In a population of newly-diagnosed, untreated essential hypertensive and normotensive individuals, endothelial function of skin microcirculation is inversely associated with carotid stiffness, an emerging tool in cardiovascular risk prediction.

Background: Diabetes mellitus (DM) and hypertension (EH) are both associated with micro- and macro-vascular damage. Microalbuminuria is a recognized marker of sub-clinical target organ damage in both DM and EH. However, it’s determinants in newly diagnosed DM with or without EH remain unclear. Methods: We enrolled consecutive newly diagnosed DM patients, recording history, demographics, renal, lipid and glycemic profile, office and ambulatory blood pressure, macro-(pulse-wave velocity/PWV) and micro-vascular (microalbuminuria in 24-hour urine) damage and subclinical atherosclerosis (intima-media thickness). Results: We studied 65 DM patients (40 male: 25 female, aged 57±11 years), with a median duration from diagnosis of 2 weeks. Their fasting glucose was 121.5 (IR: 36) mg/dl, HbA1c: 7.47 (IR: 2)%. Among them, 26 had already been diagnosed with EH (median duration of 8 (IR: 8) years), while 17 were diagnosed with EH at the time of DM diagnosis. No difference was observed between the two groups, except for significantly higher office and ambulatory BP and PWV in the newly diagnosed EH patients. Microalbuminuria was associated with fasting glucose (p = 0.04), HbA1c (p = 0.002), serum creatinine (p = 0.035), glomerular filtration rate (GFR) (p = 0.002), office systolic (p = 0.009) and diastolic (p = 0.026) BP and PWV (p = 0.031). In the multivariate analysis, HbA1c (beta = 0.351, p = 0.015) was the only determinant of microalbuminuria. Conclusions: Our study indicates that hyperglycaemia has a significant impact on microalbuminuria even in patients with newly diagnosed DM and EH (either newly diagnosed with high BP values or longer lasting), emphasizing on the need of early and effective glycemic control.