Evaluating the Prognostic Significance of Circulating Biomarkers of End Organ Damage in Hypertension

Mbeta, E ORCID: 0009-0000-6210-3062, Williams, K, Yates, J ORCID: 0000-0001-8629-4430, Sankaranarayanan, R ORCID: 0000-0003-2355-2011, Penson, P ORCID: 0000-0001-6763-1489, Lip, GYH ORCID: 0000-0002-7566-1626 and McDowell, G ORCID: 0000-0002-2880-5236 (2025) Evaluating the Prognostic Significance of Circulating Biomarkers of End Organ Damage in Hypertension. Journal of Clinical Medicine, 14 (17).

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Abstract

Background: Most patients with hypertension exhibit elevated and detectable levels of natriuretic peptides, particularly BNP and NT-proBNP, as well as troponin concentrations. However, the prognostic relevance of this finding has not been clearly established in patients who have hypertension without heart failure (HF). In this review, we aimed to evaluate the prognostic utility of BNP/NT-proBNP alongside troponin T/I for risk stratification in hypertensive patients, excluding those with HF. Methods: This systematic review was registered in PROSPERO (CRD42024552031). A systematic literature search was conducted using two online databases, Ovid Medline and Web of Science, to identify studies. Data retrieved from articles were used in line with the PRISMA statement guidelines. Participants were aged ≥ 18 years with hypertension. The primary end point was a major adverse cardiac event (MACE) and its individual components. Descriptive synthesis was performed, and data are presented in tabular form. Results: Seventeen studies (70,021 participants) were retrieved for analysis comprising eight prospective cohort studies, six randomized controlled trials, and three retrospective studies. The review evaluated cardiac biomarkers: BNP (n = 6), NT proBNP (n=9), troponin T (n = 4), and troponin I (n = 7). Studies predicted composite MACE (n = 8), all-cause mortality (n = 7), HF (n = 6), and atrial fibrillation (n = 3) outcomes. Cardiac biomarkers showed a strong association with reported outcomes. However, heterogeneity in biomarker thresholds and methodologies limited comparability. Conclusions: The obtained results suggest that elevated cardiac biomarkers BNP/NT-proBNP and troponin I are associated with significantly higher risk of MACE and are powerful predictors in clinical setting. However, large-scale studies are required to validate the robustness and prognostic utility of these biomarkers.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences; 32 Biomedical and clinical sciences
Subjects:	Q Science > QH Natural history > QH301 Biology
Divisions:	Pharmacy and Biomolecular Sciences
Publisher:	MDPI
Date of acceptance:	20 August 2025
Date of first compliant Open Access:	26 August 2025
Date Deposited:	26 Aug 2025 12:03
Last Modified:	26 Aug 2025 12:15
DOI or ID number:	10.3390/jcm14175935
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26994

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