Navigating Hypertension: Biomarkers as Precision Tools for Diagnosis, Prognosis, and Treatment Guidance

Abstract

Detecting hypertension early is vital for preventing and addressing diverse health risks. It persists as a key contributor to cardiovascular diseases, neurological disorders, renal complications, and various other serious health conditions. Over a billion people worldwide suffered from hypertension in 2019, a figure that has doubled since 1990.  Essential hypertension, which accounts for approximately 90% of cases of hypertension, has an unclear cause. Biomarkers are flexible diagnostic tools that can affect the decisions made by healthcare professionals and help educate patients about diagnosis, prognosis, early detection, and treatment interventions. The literature on biomarkers has been reviewed in this study. Therefore, it's becoming more and more crucial to identify reliable biomarkers and use them to forecast, diagnose, and track the effectiveness of hypertension treatments.

Hypertension is linked to heightened activity in biochemical markers indicating endothelial dysfunction and reduced nitric oxide production. It is also linked to problems with glucose metabolism and blood lipids, mainly cholesterol levels from LDL and VLDL, as well as inflammation markers such as CRP, cytokines, and adhesion molecules. Plasma cyclophilin-A (CyP-A) and frequently mentioned recurrent biomarkers such as tryptophan, pyruvate, lactic acid, and valine may serve as biomarkers for essential hypertension (EH).

Growth and differentiation factor-15, red cell distribution width, uric acid, and creatinine are prognostic biomarkers for patients with pulmonary arterial hypertension (PAH). Additionally, inflammatory biomarkers including interleukin-6, angiopoietins, and microRNAs are also considered.

The fibrosis-4 index and the improved liver fibrosis test are commonly used blood indicators to evaluate portal hypertension (PH). At the same time, vibration-controlled transient elastography is widely used as the most often used technique for elastography. Equally, significant techniques for assessing portal hypertension (PH) comprise of plasma cyclic guanosine monophosphate (cGMP), liver/spleen stiffness measurements (SSMs), and the hepatic venous pressure gradient (HVPG).

The measurement of uric acid, potassium, and sodium levels in the blood is essential for the identification and monitoring of hypertension in children. Copeptin also plays a significant part in this process. Likewise, the seriousness of prenatal hypertension is linked to higher amounts of interleukin-1, high levels of uric acid in the blood, and an increase in C-reactive protein in the bloodstream. Measuring the level of uric acid in the blood is an accurate and dependable diagnostic method, which demonstrates a significant association with the severity of high blood pressure in pregnant women diagnosed with pre-eclampsia.