Abstract

While CVD risk factors are well known to enhance the development of atherosclerotic lesions in large arteries, there is now compelling evidence that the structure and function of the microvasculature (arterioles, capillaries and venules ~150 μm or less in diameter) that reside within the tissue parenchyma, are also profoundly altered by CVD risk factors. Obesity, hypertension and impaired insulin-mediated glucose disposal are all associated with an abnormal microvascular endothelium-dependent vasodilator response, capillary recruitment, and a reduced capillary density and network architecture. Furthermore, there is growing evidence for the negative impact of the maternal environment on the long term CV health of her child and that mal-adaptations in the offspring peripheral vascular structure and function during development may represent an important and additional risk determinant in the susceptibility to the development of cardio-metabolic disease in adult life. Study of the microcirculation offers an important tool in the early identification of vascular dysfunction, in disease risk stratification, and in the evaluation of the impact of modifiable (lifestyle and environmental) risk factors and efficacy of intervention.