The aim of this double blind placebo controlled crossover study is to show that apart from decreasing blood pressure felodipine improves microcirculation. 30 patients with essential hypertension and manifest microangiopathy were included. No patients dropped out on account of side effects although these occurred in the expected frequencies. The study phases each extended for a week (10 mg/d felodipine or respectively a placebo). Blood pressure, blood and serum values, nail fold capillary circulation and oxygen partial pressure in muscle were measured. The blood pressure in the placebo phase remained constant. The increase of erythrocyte velocity in cutaneous capillaries and oxygen partial pressure in muscle and the decrease of poorly supplied muscle areas caused by felodipine relevantly improved the microcirculation of skin and muscle by 50% and 30%. The vasomotor reserve increased by 50% owing to an antispastic effect of the substance. A theological effect was observed in the form of a decrease in plasma viscosity. Felodipine significantly and relevantly decreased by 10% the systolic and diastolic blood pressures. Apart from decreasing blood pressure Felodipine causes a relevant and significant global improvement of microcirculation in skin and skeletal muscle tissue.