Analysis of Potential Biomarkers in Hypertension

Background: Hypertension is a major global health concern and a leading contributor to cardiovascular and renal diseases. Traditional diagnostic approaches often fail to detect early or atypical forms of hypertension, underscoring the need for sensitive and specific biomarkers to enable timely diagnosis, individualized risk stratification, and improved treatment strategies. Materials and Methods: This review systematically analyzes both established and emerging biomarkers of hypertension. We evaluated traditional indicators such as renin, aldosterone, natriuretic peptides, and C-reactive protein, alongside recent findings from molecular and omics-based research, including microRNAs, DNA methylation, gut microbiota-derived metabolites, exosomal markers, inflammatory cytokines, and proteomic and metabolomic signatures. Results: Traditional biomarkers remain essential in diagnosing secondary hypertension but lack specificity and are affected by multiple confounders. Emerging biomarkers demonstrate promising potential for early detection and mechanistic insight. Circulating microRNAs (e.g., miR-21, miR-126), epigenetic modifications (e.g., DNA methylation of CYP11B2), and gut-derived metabolites (e.g., TMAO, SCFAs) are linked to vascular dysfunction, inflammation, and salt sensitivity. Proteomic markers such as ANGPTL3 and MMP-9, along with metabolomic profiles involving BCAAs and oxylipins, correlate with hypertensive phenotypes. Exosomal RNAs and cytokines (e.g., IL-6, TNF-α) further reflect immune and endothelial activity. Multi-omics integration and machine learning approaches are increasingly used to refine biomarker panels for clinical application. Conclusion: Novel biomarkers provide deeper insight into hypertension pathophysiology and offer opportunities for personalized diagnosis and therapy. However, clinical translation requires validation in large cohorts and standardization of analytical methods. Continued integration of omics technologies will be essential for the future of hypertension management.