MicroRNA expression profile associated with coronary heart disease in patients with resistant arterial hypertension.

BACKGROUND: Resistant arterial hypertension (RAH) is associated with a high burden of cardiovascular complications, particularly coronary heart disease (CHD). MicroRNAs (miRNAs) are important regulators of cardiovascular remodeling and metabolic dysfunction; however, data regarding peripheral blood mononuclear cell (PBMC) miRNA expression in patients with RAH and concomitant CHD remain limited. This study aimed to evaluate PBMC miRNA expression profiles associated with CHD in patients with RAH and to explore their relationship with metabolic abnormalities. METHODS: In this cross-sectional study, 115 patients with RAH were enrolled. PBMCs were isolated from peripheral blood and expression levels of selected microRNAs were quantified using TaqMan-based quantitative real-time PCR. Relative expression was calculated using the 2-ΔΔCT method and expressed as log-transformed relative quantification (logRQ). Patients were stratified according to the presence of CHD. Correlation analyses, subgroup comparisons, and receiver operating characteristic (ROC) analyses were performed. RESULTS: Compared with patients with isolated RAH, those with concomitant CHD exhibited significantly higher PBMC expression levels of miR-195 (p = 0.0148), miR-26b (p = 0.0166), miR-208 (p = 0.0435), and miR-320 (p = 0.0402). These microRNAs demonstrated strong positive intercorrelations, indicating a coordinated expression pattern. Within the CHD subgroup, expression levels of all four microRNAs were significantly higher in patients with type 2 diabetes (T2D) and positively correlated with glycated hemoglobin and body mass index. ROC analysis demonstrated modest discriminative ability for identifying T2D within the CHD subgroup, with the highest performance observed for miR-195 (AUC = 0.706). CONCLUSION: Patients with RAH and concomitant CHD exhibit a distinct PBMC microRNA expression profile characterized by increased expression of miR-195, miR-208, miR-26b, and miR-320. The association of these microRNAs with T2D and markers of metabolic dysfunction suggests that they may reflect the combined cardiovascular and metabolic disease burden in patients with advanced hypertension.