OBJECTIVE: To examine whether forearm postischemic skin reactive hyperemia (SRH) measured by laser Doppler flowmetry (LDF) can be used to explore microvascular function and whether LDF response is related to cardiovascular (CV) risk in a population study. METHODS: SRH of the forearm defined as the percentage increase in cutaneous blood flow from resting conditions to peak dilation following a 2 min upper arm occlusion and CV risk factors were measured prospectively in 862 healthy females screened for cardiovascular risk factors in the context of a campaign designed to promote the 'control' of CV risk factors in women. RESULTS: The Framingham risk score was constructed from age, sex, systolic and diastolic blood pressure, diabetes, total and high-density lipoprotein-cholesterol and left ventricular hypertrophy (Cornell product. The Cornell product for women was calculated as the QRS duration (ms) (R aVL + S V3 + 6 mV)). Although the score was low in this female population (CV event risk at 10 years 7.89) (95% confidence interval, 7.49-8.30) aged 40 to 75 years, we observed an inverse correlation between SRH of the forearm and the CV risk score ( P<0.001). Hormonal replacement therapy (39.4% of the study population was on hormone replacement therapy) had no significant influence on forearm postischemic SRH in this particular population. CONCLUSIONS: This study shows that in a very low CV risk female population, a significant correlation can be observed between the weight of CV risks and the impairment of postischemic forearm SRH. Thus, skin laser Doppler flowmetry may represent a valuable, simple and non-invasive tool to assess and monitor microvascular function in future prospective observational and interventional studies.