Proteomic investigations into hypertension: what’s new and how might it affect clinical practice?

ABSTRACT

Introduction: Hypertension is a multifactorial disease that has, thus far, proven to be a difficult target for pharmacological intervention. The application of proteomic strategies may help to identify new biomarkers for the early diagnosis and prompt treatment of hypertension, in order to control blood pressure and prevent organ damage.

Areas covered: Advances in proteomics have led to the discovery of new biomarkers to help track the pathophysiological processes implicated in hypertension. These findings not only help to better understand the nature of the disease, but will also contribute to the clinical needs for a timely diagnosis and more precise treatment. In this review, we provide an overview of new biomarkers identified in hypertension through the application of proteomic techniques, and we also discuss the difficulties and challenges in identifying biomarkers in this clinical setting. We performed a literature search in PubMed with the key words ‘hypertension’ and ‘proteomics’, and focused specifically on the most recent literature on the utility of proteomics in hypertension research.

Expert opinion: There have been several promising biomarkers of hypertension identified by proteomics, but too few have been introduced to the clinic. Thus, further investigations in larger cohorts are necessary to test the feasibility of this strategy for patients. Also, this emerging field would profit from more collaboration between clinicians and researchers.

KEYWORDS:

• Hypertension
• precision medicine
• proteomics

Article highlights

• Hypertension is a complex and multifactorial condition that is considered the leading cause of cardiovascular mortality and is currently defined by clinical criteria.

• Considerable efforts have been made to better delineate the pathophysiology and molecular mechanisms involved in hypertension; however, these were mostly targeted approaches with predefined biomarkers.

• Advances in proteomics in the past 20 years have led to a much higher level of understanding of the pathophysiological processes implicated in cardiovascular diseases, including hypertension, which have led to the discovery of proteins related to inflammation, immune system, endothelial dysfunction and renal damage.

• The continuous improvements in mass spectrometry and the collaboration between researchers and clinicians should allow for the introduction of validated biomarkers into routine clinical use in the near future.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by the Instituto de Salud Carlos III co-supported by Fondo Europeo de Desarrollo Regional (Fondos FEDER), grant numbers: PT13/0001/0013, PI14/01917, PI14/01841, CP15/00129, PI17/01093, PI17/01193, FI18/00261, PI18/00995" for Funding: ISCIII (“PT13/0001/0013, PI14/01917, PI14/01841, CP15/00129, PI17/01093, PI17/01193, FI18/00261, PI18/00995”), co-funded by ERDF/ESF, “Investing in your future”.