Serum ATP1A1 and epinephrine as potential biomarkers for essential hypertension ‒ a case-control study

Abstract

Introduction and aim. Essential hypertension is a leading cause of global morbidity driven by complex genetic and physiological interactions. The roles of the Na+/K+-ATPase pump, sympathetic nervous system, and electrolyte balance are critical, yet their simultaneous interaction remains unexplored. This study aimed to investigate the serum levels of Na+/K+-ATPase alpha-1 subunit (ATP1A1), epinephrine, and key electrolytes (sodium, potassium, chloride, and calcium) in hypertensive patients, providing a novel multi-marker approach to evaluate their potential as diagnostic biomarkers. Material and methods. We enrolled 80 hypertensive patients and 40 normotensive controls in this cross-sectional study. Serum ATP1A1 and epinephrine levels were measured by ELISA, and electrolytes were analyzed using an ion-selective electrode analyzer. Results. Hypertensive patients exhibited significantly higher serum levels of ATP1A1 (430±190 vs. 161±71.16 ng/L), epinephrine (339±188 vs. 116.5±38.6 ng/L), sodium, chloride, and calcium, with significantly lower potassium (all p<0.001 ROC analysis demonstrated a promising discriminatory ability for ATP1A1 (AUC=0.92) and epinephrine (AUC=0.94). Multiple regression analysis identified ATP1A1, epinephrine, and chloride levels as significant independent predictors of systolic blood pressure. Conclusion. Patients with essential hypertension display a distinct biochemical signature of elevated serum ATP1A1 and epinephrine levels coupled with significant electrolyte disturbances. These preliminary findings suggest potential value as biomarkers for essential hypertension, although extensive validation in larger, independent cohorts is required before clinical application can be considered.