Key result
Gut microbiota diversity, specifically the ACE index, was positively associated with blood pressure control (adjusted OR 1.305) and strongly predicted compliance (AUC 85.282) in hypertensive patients.
Why the study?
To investigate whether the intestinal flora of patients with hypertension can predict long-term blood pressure control.
Does gut microbiota composition predict long-term blood pressure control in patients with primary grade-2 hypertension?
Cross-Sectional (n=125)
No
Does gut microbiota composition predict long-term blood pressure control in patients with primary grade-2 hypertension?
Odds Ratio: 1.305 (95% CI 1.053–1.618)
p-value: p=0.015
Specific gut microbiota signatures, including ACE index and genus levels of Streptococcus and Akkermansia, can predict long-term blood pressure control in patients with primary hypertension.
Microbiota differences should not guide hypertension care; leaves open predictive value pending prospective validation.
OBJECTIVES: To investigate the prediction of long-term blood pressure control using the intestinal flora of patients with hypertension. METHODS: A total of 125 patients with primary grade-2 hypertension who attended the cardiovascular department of Hebei Province Hospital of Chinese Medicine between April 2021 and April 2022 were enrolled; these included 65 patients with substandard long-term blood pressure control (the uncontrolled group) and 60 patients with standard long-term blood pressure control (the controlled group). General clinical data and data on morning stools and diet were recorded for all the enrolled patients. The 16 s rDNA sequencing of faecal intestinal flora was also performed to analyse the differences in intestinal flora between the two groups of patients and to investigate the relationship between blood pressure compliance and the presence of flora. RESULTS: The intestinal flora of the two groups of patients differed in terms of the Firmicutes-Bacteroidetes ratio (F/B), α-diversity analysis (Chao1, ACE and Shannon) results and β-diversity analysis results. At the genus level, the number of Streptococcus and Paraprevotella in patients in the uncontrolled group was greater than that of the controlled group, and the level of Akkermansia and Bifidobacterium was lower than that in the controlled group. A logistic regression analysis of the difference factors found differences in ACE, F/B, Streptococcus, Paraprevotella and Akkermansia in the two groups; these differences remained after correcting for age, gender and body mass index. The receiver operating characteristic curves revealed the following: ACE (area under the curve [AUC] = 85.282), Streptococcus (AUC = 82.705), Akkermansia (AUC = 77.333), Paraprevotella (AUC = 66.154) and F/B (AUC = 60.436). CONCLUSIONS: There were significant differences in the intestinal flora of the patients in the controlled blood group compared with that of the uncontrolled group. Therefore, the ACE, genus levels of Streptococcus and Akkermansia could provide some prediction of late blood pressure compliance or non-compliance in patients with hypertension.
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Kang et al. (2023) conducted a cross-sectional in Primary grade-2 hypertension (n=125). Gut microbiota composition (ACE index) vs. Substandard long-term blood pressure control was evaluated on Blood pressure attainment (standard vs substandard control) (OR 1.305, 95% CI 1.053-1.618, p=0.015). Gut microbiota diversity, specifically the ACE index, was positively associated with blood pressure control (adjusted OR 1.305) and strongly predicted compliance (AUC 85.282) in hypertensive patients.
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