Microvascular Responsiveness in Obesity: Implications for Therapeutic Intervention

Overview

Journal Br J Pharmacol

Publisher Wiley

Specialty Pharmacology

Date 2011 Jul 30

PMID 21797844

Citations 21

Authors

Zsolt Bagi

Attila Feher

James Cassuto

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Obesity has detrimental effects on the microcirculation. Functional changes in microvascular responsiveness may increase the risk of developing cardiovascular complications in obese patients. Emerging evidence indicates that selective therapeutic targeting of the microvessels may prevent life-threatening obesity-related vascular complications, such as ischaemic heart disease, heart failure and hypertension. It is also plausible that alterations in adipose tissue microcirculation contribute to the development of obesity. Therefore, targeting adipose tissue arterioles could represent a novel approach to reducing obesity. This review aims to examine recent studies that have been focused on vasomotor dysfunction of resistance arteries in obese humans and animal models of obesity. Particularly, findings in coronary resistance arteries are contrasted to those obtained in other vascular beds. We provide examples of therapeutic attempts, such as use of statins, ACE inhibitors and insulin sensitizers to prevent obesity-related microvascular complications. We further identify some of the important challenges and opportunities going forward.

Linked Articles: This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3.

Citing Articles

Improvement of Microvascular Function in Patients with Morbid Obesity After Bariatric Surgery Revealed by Imaging Photoplethysmography.

Vasilieva M, Kashchenko V, Shmidt E, Mizeva I, Dolotovskaya P, Zaytsev V Obes Surg. 2025; 35(3):1001-1008.

PMID: 39934520 DOI: 10.1007/s11695-025-07741-8.

LDL-c/HDL-c Ratio and NADPH-Oxidase-2-Derived Oxidative Stress as Main Determinants of Microvascular Endothelial Function in Morbidly Obese Subjects.

Santos J, La Fuente J, Fernandez A, Ruano P, Angulo J Antioxidants (Basel). 2024; 13(9).

PMID: 39334798 PMC: 11444145. DOI: 10.3390/antiox13091139.

Impaired Capillary Recruitment Capacity in Obesity: A Subgroup Analysis of Prospective Observational Study on Anesthesia Effects.

Jeon S, Lee H, Ri H, Cho A, Kim H, Hong J Med Sci Monit. 2024; 30:e943036.

PMID: 38308426 PMC: 10848865. DOI: 10.12659/MSM.943036.

The weight of obesity in hypertrophic cardiomyopathy.

Zaromytidou M, Savvatis K Clin Med (Lond). 2023; 23(4):357-363.

PMID: 37524411 PMC: 10541040. DOI: 10.7861/clinmed.2023-0194.

The impact of obesity on the regulation of muscle blood flow during exercise in patients with heart failure with a preserved ejection fraction.

Ratchford S, Lee J, Bunsawat K, Alpenglow J, Zhao J, Ma C J Appl Physiol (1985). 2022; 132(5):1240-1249.

PMID: 35421322 PMC: 9126213. DOI: 10.1152/japplphysiol.00833.2021.

References

Iacobellis G . True uncomplicated obesity is not related to increased left ventricular mass and systolic dysfunction. J Am Coll Cardiol. 2004; 44(11):2257. DOI: 10.1016/j.jacc.2004.09.012. View

Cai H, Harrison D . Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. Circ Res. 2000; 87(10):840-4. DOI: 10.1161/01.res.87.10.840. View

Bychkov R, Burnham M, Richards G, Edwards G, Weston A, Feletou M . Characterization of a charybdotoxin-sensitive intermediate conductance Ca2+-activated K+ channel in porcine coronary endothelium: relevance to EDHF. Br J Pharmacol. 2002; 137(8):1346-54. PMC: 1573623. DOI: 10.1038/sj.bjp.0705057. View

Jay M, Ren J . Peroxisome proliferator-activated receptor (PPAR) in metabolic syndrome and type 2 diabetes mellitus. Curr Diabetes Rev. 2008; 3(1):33-9. DOI: 10.2174/157339907779802067. View

Romero-Corral A, Sert-Kuniyoshi F, Sierra-Johnson J, Orban M, Gami A, Davison D . Modest visceral fat gain causes endothelial dysfunction in healthy humans. J Am Coll Cardiol. 2010; 56(8):662-6. PMC: 3951914. DOI: 10.1016/j.jacc.2010.03.063. View

Marchioli R, Schweiger C, Levantesi G, Tavazzi L, Valagussa F . Antioxidant vitamins and prevention of cardiovascular disease: epidemiological and clinical trial data. Lipids. 2002; 36 Suppl:S53-63. DOI: 10.1007/s11745-001-0683-y. View

Gonzalez M, Selwyn A . Endothelial function, inflammation, and prognosis in cardiovascular disease. Am J Med. 2003; 115 Suppl 8A:99S-106S. DOI: 10.1016/j.amjmed.2003.09.016. View

Kadowaki T, Hara K, Yamauchi T, Terauchi Y, Tobe K, Nagai R . Molecular mechanism of insulin resistance and obesity. Exp Biol Med (Maywood). 2003; 228(10):1111-7. DOI: 10.1177/153537020322801003. View

Nawano M, Anai M, Funaki M, Kobayashi H, Kanda A, Fukushima Y . Imidapril, an angiotensin-converting enzyme inhibitor, improves insulin sensitivity by enhancing signal transduction via insulin receptor substrate proteins and improving vascular resistance in the Zucker fatty rat. Metabolism. 1999; 48(10):1248-55. DOI: 10.1016/s0026-0495(99)90263-9. View

10.

Rapola J, Virtamo J, Haukka J, Heinonen O, Albanes D, Taylor P . Effect of vitamin E and beta carotene on the incidence of angina pectoris. A randomized, double-blind, controlled trial. JAMA. 1996; 275(9):693-8. DOI: 10.1001/jama.1996.03530330037026. View

11.

Oflaz H, Ozbey N, Mantar F, Genchellac H, Mercanoglu F, Sencer E . Determination of endothelial function and early atherosclerotic changes in healthy obese women. Diabetes Nutr Metab. 2003; 16(3):176-81. View

12.

Henderson K, Turk J, Rush J, Laughlin M . Endothelial function in coronary arterioles from pigs with early-stage coronary disease induced by high-fat, high-cholesterol diet: effect of exercise. J Appl Physiol (1985). 2004; 97(3):1159-68. DOI: 10.1152/japplphysiol.00261.2004. View

13.

Chemaly E, Hadri L, Zhang S, Kim M, Kohlbrenner E, Sheng J . Long-term in vivo resistin overexpression induces myocardial dysfunction and remodeling in rats. J Mol Cell Cardiol. 2011; 51(2):144-55. PMC: 3124590. DOI: 10.1016/j.yjmcc.2011.04.006. View

14.

Berg A, Scherer P . Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 96(9):939-49. DOI: 10.1161/01.RES.0000163635.62927.34. View

15.

Vane J, Anggard E, Botting R . Regulatory functions of the vascular endothelium. N Engl J Med. 1990; 323(1):27-36. DOI: 10.1056/NEJM199007053230106. View

16.

Frisbee J, Stepp D . Impaired NO-dependent dilation of skeletal muscle arterioles in hypertensive diabetic obese Zucker rats. Am J Physiol Heart Circ Physiol. 2001; 281(3):H1304-11. DOI: 10.1152/ajpheart.2001.281.3.H1304. View

17.

McNally P, Lawrence I, Watt P, Hillier C, Burden A, Thurston H . The effect of insulin on the vascular reactivity of isolated resistance arteries taken from healthy volunteers. Diabetologia. 1995; 38(4):467-73. DOI: 10.1007/BF00410285. View

18.

Hashimoto M, Akishita M, Eto M, Kozaki K, Ako J, Sugimoto N . The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation. Int J Obes Relat Metab Disord. 1998; 22(5):477-84. DOI: 10.1038/sj.ijo.0800620. View

19.

Rapola J, Virtamo J, Ripatti S, Haukka J, HUTTUNEN J, Albanes D . Effects of alpha tocopherol and beta carotene supplements on symptoms, progression, and prognosis of angina pectoris. Heart. 1998; 79(5):454-8. PMC: 1728686. DOI: 10.1136/hrt.79.5.454. View

20.

Borbouse L, Dick G, Asano S, Bender S, Dincer U, Payne G . Impaired function of coronary BK(Ca) channels in metabolic syndrome. Am J Physiol Heart Circ Physiol. 2009; 297(5):H1629-37. PMC: 2781383. DOI: 10.1152/ajpheart.00466.2009. View