Nailfold Capillary Abnormalities as Early Indicators of Systemic Microvascular Dysfunction in Apparently Healthy Adults

Abstract

Microvascular abnormalities often precede the clinical manifestation of cardiovascular and metabolic disorders. Nailfold capillaroscopy is a simple, non-invasive technique that may assist in identifying early microvascular changes in asymptomatic individuals. This observational study explored the prevalence of nailfold capillary abnormalities among apparently healthy adults and evaluated their potential association with subclinical microvascular dysfunction. Adult volunteers without previously diagnosed cardiovascular or autoimmune diseases underwent nailfold capillaroscopic examination and routine clinical assessment. Common findings included capillary tortuosity, mild dilatation, and occasional microhemorrhages. Participants demonstrating multiple capillary abnormalities more frequently exhibited borderline vascular risk factors, including elevated body mass index and higher resting blood pressure. Although the findings cannot establish causality, they suggest that nailfold capillaroscopy may serve as a useful adjunctive screening method for identifying individuals who could benefit from preventive cardiovascular assessment. Larger prospective studies are warranted to determine its predictive value in routine clinical practice.