Epigenetic Biomarkers in Hypertension: Towards Precision Cardiovascular Medicine

Abstract

Background: Hypertension is a major cardiovascular disorder. Epigenetic biomarkers, particularly histone modifications and non-coding RNAs, offer potential for early detection and therapeutic targeting in precision cardiovascular medicine. Objective: This study evaluates the role of histone acetylation and circulating microRNAs in hypertensive patients, aiming to establish predictive biomarkers for vascular remodeling, left ventricular hypertrophy, and overall disease severity. Methods: A cross-sectional study was conducted at the Department of Medicine, Ibne Sina Hospital, Dhaka, Bangladesh, from June 2023 to June 2024. Eighty-six hypertensive patients were enrolled. Histone acetylation (H3K9ac) was assessed using chromatin immunoprecipitation assays, while circulating microRNAs (miR-21, miR-155) were quantified through qRT-PCR. Clinical parameters, echocardiographic findings, and vascular stiffness indices were statistically analyzed using SPSS v26. Results: The mean systolic blood pressure was 156.8 ± 12.4 mmHg and diastolic 97.3 ± 8.6 mmHg. Histone H3K9 hypoacetylation was observed in 38.4% (n=33), significantly correlated with carotid-femoral pulse wave velocity (mean 12.3 ± 2.1 m/s vs. 9.6 ± 1.8 m/s; p=0.003). Circulating miR-21 was elevated in 62.8% (n=54), positively associated with left ventricular mass index (r=0.46, p=0.005). MiR-155 levels were reduced in 44.1% (n=38), inversely related to systolic BP (r=-0.38, p=0.008). Multivariate regression indicated H3K9 hypoacetylation explained 21% variance in vascular stiffness (R²=0.21, β=0.39, p=0.002). Conclusion: Histone hypoacetylation and dysregulated microRNAs strongly correlate with hypertension severity and cardiovascular remodeling. These biomarkers show translational potential for precision medicine, guiding individualized diagnostics and therapeutic interventions.