Abstract|Stroke 3| Volume 357, SUPPLEMENT 1, e105, October 15, 2015

Blood based biomarkers to identify subclinical brain damage in essential hypertension

      Background: Neuroimaging has demonstrated that subclinical brain damage in essential hypertension is more prevalent than cardiovascular or renal impairment; nevertheless, screening for nervous system involvement is difficult due to low accessibility and high cost techniques.
      Objective: To explore if hemochemical markers of brain damage and inflammation could predict the presence of subclinical brain damage in hypertensive patients.
      Patients and methods: 101 patients with essential hypertension and 53 controls with no clinical evidence of neurological disease were recruited. Serum concentrations for two brain specific proteins (S100B and neuron specific enolase, NSE) and for inflammatory markers (C-reactive protein, CRP; α1-antitrypsine, AAT; C3 and C4 complements) were determined. Target organ damage (TOD) to the brain, heart and kidneys was evaluated in HT patients. Patient and Institutional Review Board approval were obtained.
      Results: Multiple regression analysis revealed that only NSE and CRP were independently associated with the condition of being hypertensive. NSE was associated to diastolic blood pressure and grade of retinopathy. TOD to the 3 organs was evaluated in 34 patients, showing damage to the brain in 70.6%, heart in 58.5% and kidneys in 50%. NSE was associated with more severe MRI damage (white matter hyperintensities), while inflammatory markers were not related to TOD. After ROC analysis, NSE (cutoff level: 11 μg/L) was found to predict more severe MRI lesions with 84% sensitivity and 55% specificity.
      Conclusion: Serum NSE could constitute a starting point for future investigations in the field of blood based biomarkers for the detection of subclinical brain damage in arterial hypertension.