Urate-lowering for blood pressure control in adults: another nail in the coffin?

Numerous observational studies have reported an association between serum urate and elevated blood pressure in adult populations (1). These observations, together with experimental in vivo studies, have generated substantial interest in the role of hyperuricaemia as a mediator of elevated blood pressure, with various postulated mechanisms, including activation of renin-angiotensin system, oxidative stress, reduced endothelial nitric oxide availability, and renal vasoconstriction (2)

Use of Biomarkers in the Evaluation and Treatment of Hypertensive Patients

The current definition of hypertension is based on blood pressure values, and blood pressure also drives treatment decisions, is the most important treatment monitoring tool and helps estimating risk of hypertension related organ damage. In an era of precision medicine additional biomarkers are needed in the diagnosis and management of patients with hypertension. In this review we outline the areas in which functional, imaging and circulating biomarkers could help in a more individualised definition of hypertension and associated risk. We will cover biomarkers for diagnosis; of pathophysiology and prediction of hypertension; response to treatment, organ damage; and to monitor treatment. A clear focus is on the vasculature, the heart and the kidneys, whereas we see a need to further develop biomarkers of cerebral function in order to diagnose cognition deficits and monitor changes in cognition in the future to support addressing the growing burden of hypertension associated vascular dementia