Endothelial Dysfunction, Microalbuminuria, and Cardiac Biomarkers as Predictors of Preeclampsia in Gestational Arterial Hypertension

ORIGINAL ARTICLE
Mokhinur A. Sadulloeva, Feruza. A. Zakirova, Saida A. Ikramova

 

For citation: Sadulloeva MA, Zakirova FA, Ikramova SA. Endothelial Dysfunction, Microalbuminuria, and Cardiac Biomarkers as Predictors of Preeclampsia in Gestational Arterial Hypertension. International Journal of Biomedicine. 2026;16(3):333-338. doi:10.21103/Article16(3)_OA1

Originally published September 5, 2026

Abstract: 

Background: Gestational arterial hypertension (GAH) affects 6–10% of pregnancies and may progress to preeclampsia (PE) in up to 46% of cases. Early identification of patients at risk for this transformation remains a critical clinical challenge. This study aimed to identify independent clinical, laboratory, and hemodynamic predictors of PE development in women with GAH.

Methods and Results: This study enrolled 160 pregnant women after 20 weeks of gestation: 54 healthy controls and 106 with GAH. Among GAH patients, 46 (43.4%) subsequently developed PE. All participants underwent assessment of flow-mediated dilation (FMD), microalbuminuria (MAU), NT-proBNP, echocardiography, and 24-hour ambulatory blood pressure monitoring (ABPM) at the initial visit. Multivariate logistic regression identified five independent predictors: FMD <10% (aOR=7.15; 95% CI 1.84–27.78; P=0.005), BMI ≥30 kg/m² (aOR=4.52; 95% CI 1.36–15.03; P=0.014), MAU >30 mg/day (aOR=4.28; 95% CI 1.08–16.97; P=0.038), non-dipper profile (aOR=3.95; 95% CI 1.05–14.86; P=0.042), and NT-proBNP >125 pg/mL (aOR=3.67; 95% CI 1.01–13.35; P=0.049). ROC analysis demonstrated the highest discriminative ability for FMD (AUC=0.849) and MAU (AUC=0.821).

Conclusion: FMD, MAU, NT-proBNP, BMI, and non-dipper profile are independent predictors of PE in GAH patients. Integration of these biomarkers may enable early risk stratification and timely intervention.

Keywords: 
flow-mediated dilation • NT-proBNP • non-dipper • body mass index
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Received July 5, 2026.
Accepted August 8 26, 2026.
© 2026 The Author(s). International Journal of Biomedicine is published by IMRDC. This is an open access article under the CC BY-NC-ND 4.0 license.