Abstract
Salt intake is one of the most important environmental factors impacting hypertension onset. Meanwhile, the potential roles of the gut microbiome (GM) in altering the health status of hosts have drawn considerable attention. Here, we aimed to perform an observational study to investigate the impact of intestinal bacterial flora in hypertensive patients with low-salt or high-salt intake. A total of 239 participants were enrolled, and their gut microbiomes, clinical and demographic details, as well as physiological parameters pertaining to the renin-angiotensin-aldosterone system and inflammatory cytokine profiles, were examined. The participants were classified into four groups based on the presence of different enterotype bacteria, as determined via cluster analysis, and salt intake: low salt/GM enterotype 1, low salt/GM enterotype 2, high salt/GM enterotype 1, and high salt/GM enterotype 2. Results show that the prevalence of hypertension was significantly lower in the low-salt/GM enterotype 2 group (27%) compared to the low salt/GM enterotype 1 group (47%; p = 0.04). Alternatively, no significant differences were observed in hypertension prevalence between the two high-salt intake groups (GM enterotype 1 = 50%, GM enterotype 2 = 47%; p = 0.83). Furthermore, The low-salt/GM enterotype 2 was higher in the relative abundances of Blautia, Bifidobacterium, Escherichia-Shigella, Lachnoclostridium, and Clostridium sensu stricto than the low-salt/GM enterotype 1. differed significantly between the GM enterotypes. These results suggested that consumption of a low-salt diet was ineffective in regulating hypertension in individuals with a specific gut bacteria composition. Our findings support the restoration of GM homeostasis as a new strategy for controlling blood pressure and preventing the development of hypertension.
Highlights
Hypertension has become an important global health issue and is a major risk factor for cardiovascular, cerebrovascular, and kidney diseases [1, 2]
25 participants were treated with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers
There were three patients treated with the other antihypertensives excluding renin-angiotensin-aldosterone system (RAAS) inhibitors
Summary
Hypertension has become an important global health issue and is a major risk factor for cardiovascular, cerebrovascular, and kidney diseases [1, 2]. Most studies show that excess sodium consumption raises BP in a dose-dependent manner; salt sensitivity, that is how BP responds to salt, varies, with less than one-third of normotensive individuals and less than one-half of hypertensive individuals classified as salt sensitive [7,8,9,10]. Known sources of such variability include genetic polymorphisms of the associated renin-angiotensin-aldosterone system (RAAS), dietary intake, and kidney disease
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