Biomarkers in Hypertension
Hypertension is a major risk factor for cardiovascular disease. Early diagnosis and timely intervention in disease progression lead to better outcomes and reduced risk. Plasma biomarkers predictive of blood pressure elevation may shed light on the underly
- PDF / 264,611 Bytes
- 10 Pages / 439.37 x 666.142 pts Page_size
- 6 Downloads / 190 Views
19.1
19
Introduction
Hypertension is a major risk factor for cardiovascular morbidity and mortality. Unlike most chronic conditions, diagnosis is relatively simple, involving the measurement of blood pressure. However, by the time hypertension is diagnosed, cardiovascular risk is already increased, due in part to target organ damage. Accordingly, early detection and intervention are critically important in preventing long-term complications. In this regard, plasma biomarkers, reflective of the early processes contributing to the development of hypertension, are of particular interest as their presence may precede and predict the onset of overt hypertension. Additionally, biomarkers may provide an insight into disease pathogenesis. The Biomarkers Definitions Working Group has defined a biomarker as ‘‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention [1].’’ In the context of hypertension, a biomarker may be more specifically defined as any characteristic that may be measured as an indicator of the presence of hypertension or susceptibility to its development. The measurement/detection of such characteristics may thereby aid in the early detection of the disease and may also provide insights into the biological/ biochemical processes underlying the development of hypertension.
R. M. Touyz (&) Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, London e-mail: [email protected] D. Burger Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada e-mail: [email protected] A. E. Berbari and G. Mancia (eds.), Special Issues in Hypertension, DOI: 10.1007/978-88-470-2601-8_19, Ó Springer-Verlag Italia 2012
237
238
R. M. Touyz and D. Burger
Fig. 19.1 Shift from a healthy to a dysfunctional endothelium during hypertension. This is associated with the production of factors that reflect endothelial injury, coagulation, vascular contractility, inflammation, and arterial remodeling. NO (nitric oxide), ROS (reactive oxygen species), SMC (smooth muscle cell)
Among the many pathophysiological factors associated with hypertension is endothelial dysfunction. Endothelial dysfunction is a shift from a healthy endothelium that serves to mediate vasorelaxation and inhibit coagulation and inflammation, to a procoagulative, proinflammatory endothelium with an impaired ability to facilitate vasorelaxation [2, 3]. Endothelial dysfunction may be considered both a cause and a consequence of hypertension in that its presence has a major impact on vascular function and is critically involved in the adaptive response to vascular stress caused by elevated blood pressure [4]. In human hypertension, endothelial dysfunction is observed in both conduit and peripheral vessels and is present at the earliest stages of disease [5, 6]. In fact, it may even precede the development of hypertension
Data Loading...
