Biomarkers of Endothelial Dysfunction in Hypertensive Nigerians: A Multi-Centre Study in South East Nigeria

Endothelial dysfunction is a pivotal early event in the pathogenesis of hypertension-related vascular disease and precedes overt atherosclerosis. This study evaluates biomarkers of endothelial dysfunction including soluble intercellular adhesion molecule-1, E-selectin, von Willebrand factor, and endothelin-1 in hypertensive Nigerians across three tertiary centres in South East Nigeria. A cross-sectional multi-centre design was employed, recruiting 200 hypertensive patients and 100 age-matched normotensive controls from Anambra, Imo, and Enugu States. Biomarkers were measured by ELISA, and their relationships with blood pressure severity, anti-hypertensive drug class, and co-morbidities were examined. Serum lipid profile, high-sensitivity CRP, and uric acid were simultaneously determined. Multivariate analysis identified predictors of worst endothelial dysfunction in this cohort. The study also compares endothelial biomarker patterns between patients on renin-angiotensin system blockers and those on calcium channel blockers, to explore differential endothelial effects of drug classes. Findings will fill a critical gap in the South East Nigerian literature on biochemical correlates of hypertensive vascular disease. Keywords: endothelial dysfunction, hypertension, von Willebrand factor, ICAM-1, South East Nigeria.