Biomarkers of Hypertension and Cardiovascular Disease
The vascular system plays an important pathophysiological role in the development of hypertension and associated cardiovascular disease. In hypertension, the vasculature undergoes characteristic functional and structural changes, including endothelial dysfunction, vascular inflammation and structural remodelling. These processes may precede overt manifestations of hypertension and often become more exaggerated as the condition evolves. As such, being able to detect early vascular changes with markers of injury may provide an index to predict the development and risk of hypertension and cardiovascular diseases. Numerous biomarkers have been identified, including inflammatory mediators, markers of oxidative stress, markers of calcification, microparticles and microRNAs amongst others. Although there is extensive research in the field, there are still no ideal markers to predict and track vascular damage. With improved biomarker assays and large data sets from population studies, together with non-invasive vascular imaging, the field will continue to develop, and hopefully clinically useful algorithms based on biomarkers could assist in better prediction of risk, stratification of disease and targeted treatment. This chapter defines biomarkers in the context of vascular damage in hypertension and focuses on some circulating factors that have been identified as vascular biomarkers.