Biomarcadores de função endotelial em doenças cardiovasculares: hipertensão

Abstract

The incidence of systemic arterial hypertension is increasing worldwide. The foundation of prevention is identification of people with hypertension. Nowadays, biomarkers are used to diagnose and stratify diseases and estimates prognosis. The objective of this study was to review articles published over the last 5 years on the subject of biomarkers of cardiovascular diseases. The PubMed, SciELO, Science Direct and MEDLINE databases were searched using the keywords: arterial hypertension, cardiovascular biomarkers, nitric oxide, endothelial function and asymmetric dimethylarginine. The studies reviewed show that cardiovascular diseases have complex etiologies. This article describes evidence demonstrating interactions between nitric oxide and asymmetric dimethylarginine that are involved in regulation, in metabolism, and in determination of intracellular levels, and also discusses other biomarkers related to hypertension. Some studies indicate that biomarkers are useful tools for prediction of cardiac events, whereas others state that they have little to contribute to assessments. Careful selection of tests and combinations of tests may be the key to validating use of biomarkers, in view of their low specificity for diagnosing hypertension.Keywords: biomarkers; hypertension; endothelial function; ADMA. ResumoA incidência de hipertensão arterial sistêmica está aumentando mundialmente. Sua prevenção baseia-se na identificação dos hipertensos. Atualmente, biomarcadores são utilizados com fins de diagnosticar, estratificar e prognosticar doenças. Neste estudo, objetivou-se revisar artigos dos últimos cinco anos relacionados a biomarcadores nas doenças cardiovasculares. Pesquisaram-se dados de PubMed, SciELO, Science Direct e MEDLINE, mediante as palavras-chave: hipertensão arterial, biomarcadores cardiovasculares, óxido nítrico, função endotelial e dimetilarginina assimétrica. Os estudos levantados mostram que as doenças cardiovasculares possuem uma etiologia complexa. Neste artigo, evidenciaram-se interações entre o óxido nítrico e a dimetilarginina assimétrica na regulação, no metabolismo e na determinação dos níveis intracelulares, e reviram-se outros biomarcadores relacionados à hipertensão. Alguns estudos indicam os biomarcadores como uma ferramenta útil na predição de eventos cardíacos, e outros reportam que eles contribuem pouco para a avaliação. A seleção e combinação desses pode ser uma alternativa para validar o uso dos biomarcadores devido à pouca especificidade existente para diagnosticar a hipertensão. Palavras

Is Uric Acid elevation a random finding or a causative agent of diabetic nephropathy?

“…Reactive oxygen radicals are formed during UA production, and it is reported that UA may be a simple and beneficial marker of increased oxidative stress. 22 With the use of allopurinol, UA levels were reduced, as were the harmful effects of UA. 23 With the decrease in UA levels, were also reported suppression of the aldosterone system of renin-angiotensin, increased nitric oxide, reduced oxidative stress, improved endothelial function, and decreased levels of markers for urinary inflammation.…”

Disfunção endotelial e Aterosclerose

“…A ADMA é considerada um marcador de risco de doença cardiovascular, pois inibem a produção do NO, prejudicando a função endotelial. Os níveis de ADMA aumentados são encontrados em indivíduos com dislipidemia, aterosclerose, hipertensão arterial, insuficiência cardíaca crônica, diabetes mellitus e insuficiência renal crônica (KRZYZANOWSKA et al, 2008;NEVES et al, 2016).…”

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