Biomarker guided management of hypertension

Purpose of review Approximately 1.28 billion people are affected by hypertension globally and the incidence of hypertension is on an upward trajectory with an aging population and increasing burden of risk factors including obesity. Despite low-cost, highly-effectively, easy-to-treat strategies, it is estimated that ∼720 million people are not receiving the treatment they need for optimal hypertension management. Several factors contribute to this including an unwillingness to be treated for an asymptomatic condition. Recent findings Biomarkers such as troponin, B-type Natriuretic Peptide (BNP), N-terminal-pro hormone BNP (NT-proBNP), uric acid, microalbuminuria have been found to be associated with adverse clinical outcomes among individuals with hypertension. Biomarkers also allow for identification of asymptomatic organ damage. Summary Biomarkers have the ability to identify higher risk individuals in whom risk-benefit for therapies may be most favorable, helping optimize the net benefit of therapy. Whether biomarkers can help guide therapy intensity and choice remains to be tested.