Biomarkers for the prediction of the development of neurocognitive disorders in young people with arterial hypertension

Background. The global increase in the prevalence of arterial hypertension (AH) and associated neurocognitive disorders, as well as the lack of effective evidence-based treatment strategies, contribute to the increasing demand for biomarkers for early diagnosis and prediction of the development of cognitive dysfunction. The potential use of such biomarkers is of great clinical importance in the prevention of the development of neurocognitive disorders in young people with AH. Purpose – to identify prognostically significant biomarkers of the development of neurocognitive disorders in young people with AH based on a comprehensive assessment of key indicators of the patientʼs health state, as well as biochemical markers of endothelial dysfunction and inflammation. Materials and Methods. Total of 91 young patients with AH took part in the study. Patients were divided into 2 groups depending on the presence of neurocognitive disorders. To achieve the goal, all patients underwent a standard general clinical examination, an assessment of neurological status and cognitive function, ambulatory blood pressure monitoring (ABPM), clinical and laboratory blood tests with lipid and glycemic profile assessment, as well as an assessment of the biochemical marker of endothelial dysfunction (endothelin-1 (ET-1)) and inflammation markers (interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP)). Results. Within the framework of studies there were identified biomarkers that have prognostic significance for the development of neurocognitive disorders in young people with hypertension. It was found that in a young person with hypertension with diurnal pulse blood pressure (PBP) above 65.5 mm Hg, neurocognitive disorders can be expected with a sensitivity of 79.5% and a specificity of 59.6%. The threshold values for predicting the development of neurocognitive disorders for blood glucose levels were ≥4.75 mmol/L with a sensitivity of 76.9% and a specificity of 57.7%, for total cholesterol (TC) levels – ≥6.25 mmol/L with a sensitivity of 53.8% and a specificity of 100.0%, for low-density lipoprotein (LDL) levels – ≥4.15 mmol/L with a sensitivity of 82.1% and a specificity of 61.5%, for hypertension duration – ≥7.5 years with a sensitivity of 84.6% and a specificity of 65.4%. Calculation of threshold values for markers of endothelial dysfunction and inflammation showed that at a serum IL-6 level ≥9.5 pg/ml with a sensitivity of 70.6% and a specificity of 89.5%, the development of neurocognitive disorders in a young person with hypertension can be expected. For the ET-1 marker, such a threshold level was ≥11.5 pg/ml with a sensitivity of 82.4% and a specificity of 89.5%, and for hsCRP – ≥13.5 mg/l with a sensitivity of 100% and a specificity of 73.7%. Conclusions. According to the results of the study, it was found that the levels of laboratory indicators such as ET-1, IL-6, hCRP, TC, LDL-C, blood glucose, as well as the diurnal PBP and the duration of the disease are of practical importance for predicting the development of neurocognitive disorders in young people with hypertension.