Introduction: The purpose of this study was to evaluate the effects of long-term oral antihypertensive treatment using centrally acting sympatho-inhibitory drugs (clonidine) and beta-blockers (metoprolol) on capillary microcirculation in the labial and periodontal mucosa. Methods: Sixty subjects were recruited for the study: 20 patients affected by hypertension in treatment with centrally-acting sympatho-inhibitory drugs (64.28 ± 11.78 years); 20 patients in treatment with beta-blockers (62.03 ± 9.84 years) and 20 healthy subjects (62.06 ± 6.72 years). We use the videocapillaroscopic technique to evaluate in vivo the microcirculation of the labial mucosa corresponding to the lower lip and of the periodontal mucosa corresponding to the central superior incisor. Results: Capillaroscopy revealed a significant increase in the length, diameter, tortuousity and density (P <0.05) of capillaries in patients affected by hypertension in treatment with centrally acting sympatho-inhibitory drugs, while beta-blockers had a lower effect on the labial and periodontal microcirculation compared to the healthy population. Conclusions: The capillaroscopic has revealed substantial modifications of the oral microcirculatory pattern in hypertensive patients in treatment with centrally-acting sympatho-inhibitory drugs than with beta-blockers.