5-021 Evaluating the prognostic significance of circulating biomarkers of end organ damage in hypertension: a systematic literature review

<h3>Background</h3> Most patients with hypertension exhibit detectable and elevated concentrations of natriuretic peptides (BNP/NTproBNP), and troponin when assessed using high-sensitivity assays. However, the prognostic relevance of this finding has not been clearly established so far in hypertensive patients without heart failure. In this systematic review, we aimed to evaluate the prognostic utility of BNP or NT-proBNP and troponin T/I for risk stratification in hypertensive patients, excluding those with heart failure. <h3>Methods</h3> This systematic review was registered in PROSPERO (CRD42024552031). A systematic literature search was conducted by two researchers independently using 2 online databases Ovid Medline and Web of Science to identify studies from 2013 to 2025. Data retrieved from articles were used in line with the PRISMA statement guidelines. The primary end point were major adverse cardiac events (MACE) – defined as a composite outcome of myocardial infarction, heart failure, atrial fibrillation, HF hospitalisation, stroke and all-cause mortality. Secondary outcomes were individual components of MACE outcome. Descriptive analysis was performed, and data presented in tabular form. <h3>Results</h3> Nineteen studies were retrieved with 7,519 participants distributed across various study designs (figure&nbsp;1): 10 prospective cohort studies, 6 randomized controlled trials, 2 retrospective studies and 1 cross-sectional study. Majority of studies predicted all-cause mortality and heart failure outcomes. Findings (figure&nbsp;2) demonstrated the clinical significance of BNP/NT-proBNP and troponin T and I in cardiac risk assessment, however, heterogeneity in biomarker focus and methodologies may limit comparability. <h3>Conclusion</h3> The obtained results suggest that elevated cardiac biomarkers BNP/NT-proBNP and troponins are associated with significantly higher risk of MACE and are powerful predictors of end organ damage. However, large-scale studies are required to validate the robustness and prognostic utility of these biomarkers within current risk stratification of patients with hypertension.