Shared Biomarkers of Arterial Hypertension and Atherosclerosis Development: Current State Analysis

Arterial Hypertension (HTN) and Atherosclerosis (AS) are the two most prevalent and deadly cardiovascular conditions worldwide, jointly responsible for the majority of cardiovascular morbidity and mortality. While traditionally studied as separate entities, accumulating evidence demonstrates that they share a broad spectrum of pathophysiological mechanisms including endothelial dysfunction, chronic low-grade inflammation, oxidative stress, Renin Angiotensin Aldosterone System (RAAS) overactivation, and dyslipidemia giving rise to a highly overlapping panel of biomarkers. In this review, we systematically analyze the current state of knowledge regarding shared circulating and functional biomarkers of HTN and AS. We focus on classical inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha), vasoactive molecules (endothelin-1, nitric oxide), lipid-related biomarkers (oxidized LDL, lipoprotein (a), PCSK9), vascular functional parameters (pulse wave velocity, carotid intima-media thickness), emerging cellular markers (neutrophil-to-lymphocyte ratio, growth differentiation factor-15, microalbuminuria), and circulating microRNAs. We present two comprehensive summary tables and extensively discuss landmark clinical trials JUPITER, CANTOS, CIRT, FOURIER, and ODYSSEY OUTCOMES that validated these biomarkers as therapeutic targets. The review also covers newer advances in miRNA profiling and microbiome-related biomarkers. An integrated understanding of these shared pathobiological pathways and their corresponding biomarkers is essential to optimize cardiovascular risk stratification, guide therapeutic decisions, and develop novel preventive strategies.