Use of Biomarkers in the Evaluation and Treatment of Hypertensive Patients

Currie, Gemma; Delles, Christian

doi:10.1007/s11906-016-0661-6

Cited by 16 publications

(20 citation statements)

References 143 publications

(112 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, even in countries with big resources, it is not possible to use MRIs for early identification of silent cerebral lesions. Therefore, there is an unmet need for biomarkers or predictors of SVD that can be used in medical practice [12].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Electroencephalographic Changes and Retinal Alterations in Subclinical Cerebrovascular Injury: A Case Report

Brown-Martínez¹

2017

Austin J Cerebrovasc Dis & Stroke

View full text Add to dashboard Cite

Small vessel disease induced by arterial hypertension is associated with an increased risk of stroke, dementia, cognitive impairment, and death. It comprises a group of lesions visible only by magnetic resonance imaging technique, which cannot be used in a comprehensive evaluation of hypertensive patient because of its cost and availability. We present an uncontrolled hypertensive patient with cardiovascular risk factors, with no history of previous cerebro vascular events presenting signs of small vessel disease on brain resonance imaging. Evident signs of hypertensive retinopathy in both eyes were observed, with micro hemorrhage and micro exudates in the left eye. Quantitative electroencephalographic analysis showed a significant increase in theta frequency, predominantly in left frontal, central and temporal regions. These findings could indicate the potential of these simpler and economical methods, in the prediction of subclinical brain damage of hypertensive patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Quantitative Electroencephalographic Changes and Retinal Alterations in Subclinical Cerebrovascular Injury: A Case Report

Brown-Martínez¹

2017

Austin J Cerebrovasc Dis & Stroke

View full text Add to dashboard Cite

show abstract

“…While the cancer arena has generated numerous companion diagnostics to guide therapy (available at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/InVitroDiagnostics/ucm301431.htm), few other areas of medicine have kept pace. However, recent work points towards the use of blood-based biomarkers for realizing the potential of precision medicine paradigms for numerous disease states including, but not limited to, multiple sclerosis (MS) (77), hypertension (78), idiopathic pulmonary fibrosis (IPF) (79), allergic diseases (76), and diabetes (80). …”

Section: Discovery Development and Validation Of Pathophysiologicalmentioning

confidence: 99%

“…However, molecular markers have the potential for the identification of specific subgroups (i.e. endophenotypes) of disease state (78) that may be more likely to benefit from specific interventions. In fact, a preliminary work shows that, by profiling the inflammatory system, it is possible to identify a specific subgroup of AD patients with detectable alterations in the inflammatory system treated in the Alzheimer’s Disease Cooperative Study (ADCS) trial who benefitted from that “failed” trial (107).…”

Section: Discovery Development and Validation Of Pathophysiologicalmentioning

confidence: 99%

“…worsening of cognition) was identified by this approach. Therefore, as demonstrated by cancer research, molecular markers may be utilized in AD and neurodegenerative diseases to identify specific subsets of patients that most likely benefit from specific interventions and differentiate them from patients who likely not benefit using the same compound (78). Additionally, given the rapidly growing graveyard of failed AD therapeutics that never made it past Phase III trials, these novel blood-based patterns can be applied to the biorepository samples from these failed trials in order to (I) demonstrate proof-of-concept and (II) provide the requisite information for novel CDx-driven clinical trials.…”

Section: Discovery Development and Validation Of Pathophysiologicalmentioning

confidence: 99%

See 1 more Smart Citation

Precision Medicine - The Golden Gate for Detection, Treatment and Prevention of Alzheimer’s Disease

Hampel¹,

O’Bryant

Castrillo

et al. 2016

J Prev Alz Dis

View full text Add to dashboard Cite

During this decade, breakthrough conceptual shifts have commenced to emerge in the field of Alzheimer’s disease (AD) recognizing risk factors and the non-linear dynamic continuum of complex pathophysiologies amongst a wide dimensional spectrum of multi-factorial brain proteinopathies/neurodegenerative diseases. As is the case in most fields of medicine, substantial advancements in detecting, treating and preventing AD will likely evolve from the generation and implementation of a systematic precision medicine strategy. This approach will likely be based on the success found from more advanced research fields, such as oncology. Precision medicine will require integration and transfertilization across fragmented specialities of medicine and direct reintegration of Neuroscience, Neurology and Psychiatry into a continuum of medical sciences away from the silo approach. Precision medicine is biomarker-guided medicine on systems-levels that takes into account methodological advancements and discoveries of the comprehensive pathophysiological profiles of complex multi-factorial neurodegenerative diseases, such as late-onset sporadic AD. This will allow identifying and characterizing the disease processes at the asymptomatic preclinical stage, where pathophysiological and topographical abnormalities precede overt clinical symptoms by many years to decades. In this respect, the uncharted territory of the AD preclinical stage has become a major research challenge as the field postulates that early biomarker guided customized interventions may offer the best chance of therapeutic success. Clarification and practical operationalization is needed for comprehensive dissection and classification of interacting and converging disease mechanisms, description of genomic and epigenetic drivers, natural history trajectories through space and time, surrogate biomarkers and indicators of risk and progression, as well as considerations about the regulatory, ethical, political and societal consequences of early detection at asymptomatic stages. In this scenario, the integrated roles of genome sequencing, investigations of comprehensive fluid-based biomarkers and multimodal neuroimaging will be of key importance for the identification of distinct molecular mechanisms and signaling pathways in subsets of asymptomatic people at greatest risk for progression to clinical milestones due to those specific pathways. The precision medicine strategy facilitates a paradigm shift in Neuroscience and AD research and development away from the classical “one-size-fits-all” approach in drug discovery towards biomarker guided “molecularly” tailored therapy for truly effective treatment and prevention options. After the long and winding decade of failed therapy trials progress towards the holistic systems-based strategy of precision medicine may finally turn into the new age of scientific and medical success curbing the global AD epidemic.

show abstract

“…3 One can assume that an individual's position on the continuum from health to overt cardiovascular disease is determined by the integrated action of genetic, environmental, and other risk factors and could, therefore, inform decision rules on initiation of preventative and therapeutic strategies. 4 Assessment of vascular function and structure is a key element of the mapping of an individual's cardiovascular health. For example, it is well established that pulse wave velocity (PWV; a measure of vascular stiffness) is an independent predictor of cardiovascular events.…”

mentioning

confidence: 99%