Exploring the Role of Oxidative Stress-Related Molecular Biomarkers in Cardiovascular Disease Progression and Therapeutic Modulations: A Systematic Analysis
Keywords:
Oxidative Stress, Reactive Oxygen Intermediates, Superoxide Dismutase, Malondialdehyde, Endothelial, Hypertension, Cardiovascular Disease, Antioxidant EffectsAbstract
ABSTRACT
Background: Oxidative stress plays a significant role in the pathogenesis of cardiovascular diseases (CVD), endothelial dysfunction and hypertension. The purpose of this study was to synthesize the evidence on the role of critical oxidative stress biomarkers in the etiology of associated diseases to determine their therapeutic potential. Methods: PRISMA 2020 guidelines were followed to conduct this study. Reported literature was searched using PubMed, Scopus, Web of Science, and Google Scholar from 2014 to 2025. Those studies that investigated certain biomarkers of oxidative stress (ROS,), glutathione peroxidase (GPx), malondialdehyde (MDA)) in the pathophysiology of CVD, endothelial dysfunction and hypertension were included. Non-English articles and studies without mechanistic or therapeutic outcomes were excluded. The risk of bias was evaluated with the help of Newcastle-Ottawa Scale, Cochrane risk of bias-2, and SYRCLE tool, and certainty of evidence was measured with help of the GRADE approach. Results: Findings of twelve studies were included in this review, which demonstrated that high level of mitochondrial ROS and MDA, and low activity of SOD and GPx were major contributor to endothelial dysfunction, hypertension and CVD. Melatonin, resveratrol, NAD precursors and mitochondrial-targeted antioxidants proved to be effective therapeutic agents. Risks of bias among included studies ranged from low to high, and the confidence of the evidence ranged from low to moderate. Conclusion: Oxidative stress biomarkers are critical in cardiovascular disease pathogenesis and hold significant therapeutic potential. Further extensive trials are needed to validate these indicators as diagnostic tools and convert targeted antioxidant therapy into successful precision medicine.
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