Abstract
Hypertension is a leading risk factor for cardiovascular diseases and can reduce life expectancy. Owing to the widespread use of antihypertensive drugs, patients with hypertension have improved blood pressure control over the past few decades. However, for a considerable part of the population, these drugs still cannot significantly improve their symptoms. In order to explore the reasons behind, pharmacomicrobiomics provide unique insights into the drug treatment of hypertension by investigating the effect of bidirectional interaction between gut microbiota and antihypertensive drugs. This review discusses the relationship between antihypertensive drugs and the gut microbiome, including changes in drug pharmacokinetics and gut microbiota composition. In addition, we highlight how our current knowledge of antihypertensive drug-microbiota interactions to develop gut microbiota-based personalized ways for disease management, including antihypertensive response biomarker, microbial-targeted therapies, probiotics therapy. Ultimately, a better understanding of the impact of pharmacomicrobiomics in the treatment of hypertension will provide important information for guiding rational clinical use and individualized use.
Highlights
Hypertension is recognized as a leading risk factor for cardiovascular disease worldwide [1]
Plateau group rats appeared Bacillus in comparison to the amoxicillintreated plain group. These results demonstrated that hypoxia at high altitudes and amoxicillin treatment can alter the gut microbiome, thereby affecting the metabolism of drugs in vivo
Pharmacokinetics results showed that compared with the plain group, the area under curve (AUC) of amoxicillin-treated plain group was significantly increased by 39.10%, while the peak time (Tmax) and plasma clearance (CL) were decreased by 48.91 and 34.71%, respectively
Summary
Hypertension is recognized as a leading risk factor for cardiovascular disease worldwide [1]. Antibiotics may affect the gut microbiome, reducing amlodipine metabolism by the intestinal microbiome and increasing drug bioavailability Nifedipine It is well-recognized that nifedipine, a non-polar drug, can be basically absorbed by the human gastrointestinal tract [63, 64]. Plateau group rats appeared Bacillus in comparison to the amoxicillintreated plain group These results demonstrated that hypoxia at high altitudes and amoxicillin treatment can alter the gut microbiome, thereby affecting the metabolism of drugs in vivo. Konop et al studied whether enalapril treatment reduces the blood TMAO level by changing the composition and ratio of gut microbiome [59] They divided Wistar rats into enalapril treatment groups (5.29 ± 0.5 mg/kg in the lowdose group and 12.6 ± 0.4 mg/kg in the high-dose group) and the control group, and analyzed the feces of each group. The composition and number of specific gut microbiota vary among individuals and can be changed rapidly, such as different dietary structures and environmental changes
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