Objective: Trimethylamine N-oxide (TMAO), a metabolite derived from gut microbiota, has been linked to cardiovascular disease. However, its role as a predictor of future hypertension (HT) remains unclear. This study aimed to determine whether plasma TMAO levels can predict the future development of HT. Design and method: This single-center prospective cohort study included 246 Thai patients free of HT at baseline, who underwent elective coronary angiography. Plasma TMAO levels were measured by NMR spectroscopy. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for predicting incident HT at 3-years follow up across TMAO quartiles, with the first quartile as the reference. Multivariate models were adjusted for age, sex, BMI, smoking, diabetes, dyslipidemia, systolic blood pressure, hs-CRP, eGFR, coronary artery disease, and statin use. Results: Among 246 participants. Higher TMAO quartiles were associated with increased odds of HT. In adjusted models, participants in the 3rd quartile had significantly higher odds of HT (OR = 4.22; 95% CI: 1.52–14.38; P = 0.009), and those in the 4th quartile had even greater odds (OR = 11.48; 95% CI: 3.24–19.66; P < 0.001). Conclusions: Higher TMAO levels were significantly associated with an increased incident of HT, particularly among those in the highest quartile. TMAO may serve as a useful biomarker for identifying patients at high risk of development HT.
Senthong et al. (Fri,) studied this question.