The significance of endothelial dysfunction biomarker assessment in the management of patients with hypertension

Authors

DOI:

https://doi.org/10.14739/2310-1210.2026.4.344089

Keywords:

hypertension, endothelial dysfunction, biomarker, hypertensive crisis, hypertensive urgency, cardiovascular diseases

Abstract

Aim. To analyze the significance of endothelial dysfunction biomarker assessment in the management of patients with arterial hypertension.

Materials and methods. A systematic review of scientific literature on the stated topic was conducted using the scientometric databases PubMed, Scopus, and Web of Science for the period 2020–2025. To identify sources addressing the significance of biomarkers of endothelial dysfunction in the management of patients with arterial hypertension, various combinations of the following keywords were used: “hypertension”, “endothelial dysfunction”, “biomarker”, “hypertensive crisis”, “hypertensive urgency”, “hypertensive emergency”, and “cardiovascular diseases”. The most relevant were selected on the basis of publication date, journal reputation, and citation count. Foundational works published prior to 2020 were selectively included where no equivalent contemporary evidence was available, in order to provide essential mechanistic and historical context for the discussed pathophysiological processes. After reviewing abstracts and full texts, 51 articles were selected for in-depth analysis.

Results. Modern research has moved beyond the traditional perception of the endothelium as a simple barrier. Current understanding recognizes the endothelium as an active regulator of vascular tone, inflammation, and hemostasis, with endothelial dysfunction (ED) serving as an early and pivotal factor in the development and progression of arterial hypertension and its complications. ED develops long before clinical symptoms appear and is maintained by a vicious cycle of interaction with elevated blood pressure. Biomarkers of ED, such as nitric oxide, endothelin-1, asymmetric dimethylarginine, von Willebrand factor, soluble adhesion molecules, endothelial microparticles, and circulating endothelial cells, reflect the degree of endothelial injury and activation. They may assist in predicting complications of hypertensive crisis and in monitoring treatment efficacy. The main limitations include the lack of standardized measurement methods, low specificity of certain markers, rapid metabolism, high cost, and limited availability. Despite these challenges, early identification of ED biomarkers has the potential to improve risk stratification, detect subclinical target organ damage, and enable timely intervention in hypertensive crisis.

Conclusions. Endothelial dysfunction is a key mechanism in the progression of hypertensive crisis and target organ damage. Its biomarkers help assess the risk of cardiovascular events and monitor treatment effectiveness; however, their widespread use is limited by low specificity and rapid metabolism, necessitating further research.

Author Biographies

Ye. V. Sid, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Associate Professor of the Department of General Practice (Family Medicine), Psychiatry and Neurology, Educational and Scientific Institute of Postgraduate Education

T. P. Sitalenko, Clinic “Family Doctor” of Shyroke Village Council

MD, physician

O. V. Soloviov, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Assistant of the Department of General Practice (Family Medicine), Psychiatry and Neurology, Educational and Scientific Institute of Postgraduate Education

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2026-07-08

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1.
Sid YV, Sitalenko TP, Soloviov OV. The significance of endothelial dysfunction biomarker assessment in the management of patients with hypertension. Zaporozhye Medical Journal [Internet]. 2026Jul.8 [cited 2026Jul.13];28(4):365-70. Available from: https://zmj.zsmu.edu.ua/article/view/344089

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Vol. 28 No. 4 (2026)

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Review

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Copyright (c) 2026 Ye. V. Sid, T. P. Sitalenko, O. V. Soloviov

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