Endothelial Function Biomarkers in Hypertension

Hypertension (HTN) is a major cardiovascular risk factor, contributing to over 10.4 million deaths annually. HTN's pathophysiology involves complex mechanisms, including altered vascular resistance and hormonal regulation. Endothelial dysfunction, a hallmark of HTN, is characterized by reduced vasodilator production and increased vasoconstrictor and inflammatory cytokine generation, leading to elevated blood pressure (BP) and vascular damage. Early detection and intervention are crucial to prevent long-term complications. Identifying biomarkers of endothelial function in HTN can aid early disease detection and offer insights into underlying mechanisms. Blood sample-derived biomarkers include nitric oxide (NO), asymmetric dimethylarginine (ADMA), matrix metalloproteinases (MMPs), vascular cell adhesion molecule-1 (VCAM- 1), intercellular adhesion molecule-1 (ICAM-1), and endothelial microparticles. Imaging-based biomarkers such as flow-mediated dilation (FMD) and coronary flow reserve (CFR) are also significant. These biomarkers provide the means to identify inflammation, endothelial dysfunction, and vascular injury, enhancing disease pathogenesis understanding. Combined with accurate BP measurements, they contribute to early diagnosis and provide valuable insights that may inform treatment strategies. Baseline and sequential plasma biomarker measurements also indicate treatment efficacy. However, large-scale, prospective population studies are necessary to fully validate these biomarkers for clinical use.