Historical, present, and emerging biomarkers in hypertension: a narrative review
Year: 2022
Type: review
Abstract: Background and Objective: Hypertension is the leading risk factor for morbidity and mortality worldwide and it is projected that by the year 2025, 1.5 billion adults across the globe will have hypertension. This review will discuss the evidence and applicability of numerous blood biomarkers studied (historical, present, and emerging) to better understand the pathophysiology, diagnosis, progression, therapeutic modalities, and efficacy of hypertension. Methods: We utilized internet-based search engines including PubMed, Google scholar, and EBSCO to identify articles of interest. The search was conducted starting between January 1, 2022 to July 30, 2022 and included all publications in English. The last database search was performed on July 30, 2022. A combination of the following MeSH terms were used: “biomarkers, hypertension”, “hypertension”, “genetic, epigenetic biomarkers”, “biomarkers in hypertension”. We used studies of multiple designs including basic science research, as well as prospective and retrospective cohort clinical studies. Key Content and Findings: Several hypertension-related biomarkers have been proposed and examined over the decades. These include components of the renin-angiotensin-aldosterone system (RAAS), such as plasma renin activity (PRA) and aldosterone, and components of the sympathetic nervous system, such as norepinephrine. Components of either or both systems are logical biomarker candidates since they play a significant role in the physiology of blood pressure regulation and the pathophysiology of hypertension. Other biomarkers studied include the albumin/creatinine ratio, a measure reflecting renal function/dysfunction, C-reactive protein (CRP), a measure reflecting inflammation, and pro-brain natriuretic peptide, a measure reflecting cardiac function and sodium and water homeostasis. Lastly, we included emerging biomarkers including adrenomedullin, and genetic/epigenetic biomarkers. While no biomarker has been found which can be applied to all patients with hypertension, their use in specific cases, particularly in the assessment of global cardiovascular risk is promising. Conclusions: In the future, emerging biomarkers such as members of the calcitonin gene-related peptide (CGRP) superfamily such as adrenomedullin and CGRP, as well as others currently in early research stages may help in the identification of persons at heightened risk for the development of hypertension and/or those with hypertension who may be at higher risk for target organ damage. In addition, the use of biomarkers could assist in monitoring responses to non-pharmacologic and pharmacologic treatment in those with newly diagnosed and established hypertension.
DOI: 10.21037/jlpm-22-27
Institutions: University of South Carolina, Rush University Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4307558791