ATHENA Study - The Role of Circulating Plasma MicroRNAs in Paediatric Patients with Untreated Primary Hypertension: Baseline Expression and Exercise-Induced Changes.

INTRODUCTION

The role of microRNA in primary hypertension (PH) remains unclear. This study examined the expression of microRNA-16, -21, -27a, -27b, -133a, and -145 in untreated hypertensive children, their response to aerobic exercise, and correlations with blood pressure (BP) and related parameters.

METHODS

A pre-post observational, hypothesis-generating study included 56 hypertensive (study group [SG]) and 59 healthy children (control group [CG]). Plasma microRNA levels and clinical, biochemical, BP, vascular, and hypertension-mediated organ damage (HMOD) parameters were assessed before and after one session of standardized aerobic exercise.

RESULTS

The baseline relative microRNA-27b (p < 0.001) and microRNA-133a (p = 0.018) expressions were significantly lower in the SG; similarly, after an exercise bout. After an exercise bout, the expression of microRNA-27b, -133a, and -145 increased in CG, whereas only the expression of microRNA-145 increased in SG. In SG, microRNA-16, -21, -27a, and -145 correlated positively with pre-exercise BP. There were no correlations between the analysed microRNA particles and parameters of HMOD. ROC analysis identified the best prognostic profile for relative microRNA-27b expression as a potential biomarker of the absence of PH. Multivariate analysis revealed the relative microRNA-16 expression as the only significant predictor of elevated diastolic BP.

CONCLUSIONS

MicroRNA-27b and microRNA-133a are underexpressed in children with PH. These particles may represent potential markers of hypertension in children and may also be associated with a lower burden of hypertension-related alterations. MicroRNA-16 may serve as a marker of diastolic hypertension.