title: Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension.
abstract: The object of this work was to explore if blood based biomarkers of brain damage could predict subclinical brain lesions and clinical outcome during follow-up in asymptomatic hypertensive patients. This was a cross-sectional study including 101 patients with essential hypertension and no clinical evidence of neurological disease and 53 healthy controls, followed by a longitudinal study of 62 hypertensive patients for an average of 33 months. Serum concentrations of two brain specific proteins (S100B and neuron specific enolase - NSE) were determined at inclusion. Fundoscopic exploration, brain MRI and echocardiographic studies were also performed. Clinical outcome at follow-up was registered: transient ischemic attack (TIA), stroke, vascular headache or migraine, cardiovascular events and death. Higher serum NSE and S100B concentrations were observed in hypertensive patients; and multiple regression analysis revealed independent associations of clinical variables and more severe white matter lesions only with NSE concentration. A panel combining two clinical variables (blood pressure>140/90 and years of hypertension>10) and serum NSE>13 μg/L predicted more severe white matter lesions with 80% sensitivity and 94.4% specificity. Higher NSE levels at inclusion were associated not only with the occurrence of vascular events related with the CNS (stroke, TIA and vascular headache), but also with an earlier presentation of these events during the follow-up period. Serum NSE concentration could be a useful biomarker to predict subclinical brain damage and future vascular events related with the CNS in hypertension. Blood based biomarkers could aid in filtering hypertensive patients with a higher risk of cerebrovascular disease for brain MRI scanning.
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: aglez@infomed.sld.cu.
authors.forename: Alina
authors.initials: A
authors.lastname: González-Quevedo
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: sergiogg@infomed.sld.cu.
authors.forename: Sergio
authors.initials: S
authors.lastname: González-García
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: zmhernandez@infomed.sld.cu.
authors.forename: Zenaida
authors.initials: Z
authors.lastname: Hernández-Díaz
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba.
authors.forename: Otman
authors.initials: O
authors.lastname: Fernández Concepción
authors.affiliation: "Cira García" Central Clinic, 18 # 4304, Alt. de Miramar, La Habana, Cuba. Electronic address: luisquevedo@infomed.sld.cu.
authors.forename: Luis
authors.initials: L
authors.lastname: Quevedo Sotolongo
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: marisol.pena@infomed.sld.cu.
authors.forename: Marisol
authors.initials: M
authors.lastname: Peña-Sánchez
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba.
authors.forename: Benjamín
authors.initials: B
authors.lastname: Márquez Rosales
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: lis@infomed.sld.cu.
authors.forename: Rosaralis
authors.initials: R
authors.lastname: Santiesteban Freixas
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: isabelfa@infomed.sld.cu.
authors.forename: Isabel
authors.initials: I
authors.lastname: Fernández-Almirall
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: cary@infomed.sld.cu.
authors.forename: María Caridad
authors.initials: MC
authors.lastname: Menéndez-Sainz
authors.affiliation: Institute of Neurology and Neurosurgery, La Habana, Cuba. Electronic address: rebeca@infomed.sld.cu.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Fernández-Carriera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010751:Phosphopyruvate Hydratase
keywords: Arterial hypertension; Blood biomarkers; Brain damage; Neuron specific enolase; S100B; White matter hyperintensity