According to the statistical data disclosed in China cardiovascular report 2018, among the 290 million patients with cardiovascular diseases in China, the number of patients with hypertension reached 245 million. At present, there is no effective means to cure hypertension in the world. Exploring the pathogenesis and new targets of hypertension is of great significance for the effective prevention and treatment of hypertension.

As we all know, the two major factors affecting blood pressure are volume and resistance. About 70% of the total peripheral resistance is provided by arterioles. Microcirculation is the key to determine peripheral resistance, with a diameter of 20 μ m~200 μ The microvascular network of M accounts for 90% of the total blood vessels in the body. Microcirculation has become a new target for the prevention and treatment of hypertension.

The basic function of microcirculation is to exchange substances between blood and tissue fluid, reasonably distribute nutrients and oxygen supply in tissues, and participate in energy transmission and information transmission between organs. Microcirculation disturbance may be involved in the whole process of the occurrence and development of hypertension, which is not only the cause but also the result of hypertension.

In recent years, Professor Tao Jun of the First Affiliated Hospital of Sun Yat sen University led the research team to continuously carry out relevant research on the occurrence, development and treatment of hypertension, deeply explore the role of microcirculatory vascular diseases in the pathogenesis of hypertension, and make important progress. The research results were published in the sub Journal of the lancet. From the clinical point of view, the microvessel density of digital fold was detected by digital fold microscope and retinal microvessel density was detected by fundus OCT, which further confirmed the existence of microcirculation rarefaction in patients with hypertension. It is the first time to creatively reveal the abnormal CXCR4 / JAK2 / sirt5 signal pathway of endothelial progenitor cells, resulting in the decline of angiogenesis mediated by mitochondrial dysfunction, resulting in the thinning of microcirculation in hypertension. It is proposed that mitochondrial dysfunction is one of the mechanisms of hypertension microcirculation rarefaction, which not only makes an important supplement to the pathogenesis of hypertension, but also provides a new therapeutic target and strategy for the prevention and treatment of hypertension microvascular rarefaction, which is of great clinical significance for the prevention and treatment of hypertension based on vascular disease.

On October 1, 2019, Professor Han Jingyan of the Department of medicine of Peking University published the latest research results of hypertension microcirculation in the Journal frontiersin Physiology - "the effect and mechanism of Yangxue Qingnao Pill on reducing cerebral microvascular exudation and neuronal damage in spontaneously hypertensive rats". This study shows that edema rarely occurs around capillaries and venules in normal brain tissue. When blood pressure rises, the arterial system shrinks, resulting in poor blood flow in capillary and venule systems, and even vascular atresia. Poor blood flow leads to insufficient oxygen and nutrients obtained by vascular endothelial cells and perivascular tissues, and finally reduces adenosine triphosphate (ATP) produced by mitochondria. This leads to the depolymerization of connexin and the opening of gap in vascular endothelial cells, resulting in the exudation of plasma albumin and water outside the blood vessel. Albumin and water exuded through capillaries and venules can stay around cerebral microvessels for a long time. The water seeping out of the microvessels will also compress the microvessels, aggravate the blood flow obstruction, and cause microcirculation dysfunction and structural disorder. This microcirculation disorder may be closely related to the increase of intracranial pressure, dizziness and headache caused by clinical hypertension. After using the antihypertensive drugs enalapril (EN) and nifedipine (NF) acting on the arterial system and the Chinese patent medicine Yangxueqingnao pill (yxqnw), which is widely used in hypertension, dizziness and headache, it was found that Yangxueqingnao pill can inhibit the plasma albumin exudation of cerebral venules in spontaneously hypertensive rats (SHR) and reduce the perivascular edema in hippocampus, Relieve microvascular atresia and improve cerebral blood flow (CBF). The antihypertensive drugs enalapril and nifedipine can only improve cerebral perfusion flow and partially reduce cerebral edema.

It can be seen that patients with hypertension should not only pay attention to arterial dilation, but also to microcirculation disorders and exudation of capillaries and venules. Comprehensive treatment of hypertension can improve the exchange of oxygen and nutrients around microvessels while controlling blood pressure, reduce organ damage, and improve clinical symptoms such as hypertension, headache, dizziness and insomnia.