European multicenter study investigates the metabolic profiles of different sub-types of hypertension
Hypertension is a major risk factor for acute adverse health events such as myocardial infarction and stroke. In addition, persistent hypertension can lead to heart failure and chronic kidney disease, for which metabolic perturbations are well-established and assessed from diagnostic, interventional, and systems medicine perspectives (for example, see Halade et al., 2019; Bahls et al., 2019; Huang et al., 2021).
Different forms of hypertension respond to different types of therapy, which means an accurate diagnosis is essential. A multicenter study involving eight European countries has investigated the metabolic differences between primary hypertension (which is driven by age and lifestyle, among other factors) and endocrine forms of hypertension (such as primary hyperaldosteronism, pheochromocytoma / paraganglioma, and Cushing syndrome, respectively).
The researchers performed data analysis in two ways: with classical approaches using univariate and multivariate statistics, and with a machine learning approach. Each approach yielded more than 25 significantly altered metabolites, with 16 metabolites overlapping between the two statistical approaches. Using the 15 most significant overlapping metabolites, an AUC of >0.8 for the separation between primary and endocrine hypertension was achieved. This suggests the identified biomarker signature is highly robust.
Understanding these metabolic signatures may enable earlier diagnosis, and/or selection of patients that should be referred to specialists to identify potential endocrine causes for their hypertension. In addition, multiple metabolites and metabolite ratios have shown to be significantly different between sub-groups of endocrine hypertension, providing additional insights into the pathology of the respective diseases. All of this means metabolomics looks increasingly promising as a way to deliver personalized care for hypertensive patients.
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Erlic Z, Reel P, Reel S, et al.: Targeted Metabolomics as a Tool in Discriminating Endocrine From Primary Hypertension. (2021) J Clin Endocrinol Metab.| https://doi.org/10.1210/clinem/dgaa954