Abstract
Background: Previous studies have indicated an association between hypertension and intestinal barrier dysfunction in mice models. The present study aims to investigate the association between hypertension and intestinal barrier impairment in humans and identify the novel potential risk factors for hypertension.Methods: Medical data from consecutive inpatients were retrospectively pooled from patient records. We compared intestinal barrier serum markers [diamine oxidase (DAO), lipopolysaccharide (LPS), and D-lactate] between those patients with and without hypertension. Moreover, the associations between intestinal barrier markers and cardiovascular risk, hypertension history, blood pressure control, hypertensive complications, and antihypertensive medication history were also analyzed.Results: Overall, 106 hypertensive and 251 normotensive subjects were included. Patients with hypertension had a higher level of DAO (28.30 vs. 18.73%, P = 0.044) and LPS (22.64 vs. 11.16%, P = 0.005). In hypertensive patients, multivariate logistic regression analyses showed that long hypertension history (≥20 years), poor control of diastolic blood pressure, cardiac and renal complications, and use of multiple antihypertensive medications were risk factors for elevated DAO, while the use of multiple antihypertensive medications was a risk factor for elevated D-lactate (P < 0.05).Conclusions: Hypertension is associated with impairment of intestinal barrier, especially in patients with long duration, poor blood pressure control, cardiac and renal complications, and use of multiple antihypertensive medications. The current study indicates that intestinal barrier dysfunction might be a potential predictor of hypertension.
Highlights
Previous studies have indicated an association between hypertension and intestinal barrier dysfunction in mice models
Our findings show that hypertensive patients had higher prevalence rates of elevated diamine oxidase (DAO) and LPS than normotensive subjects, which indicates that hypertension is associated with serious intestinal barrier impairment, including small intestinal epithelium injury and endotoxin translocation
To the best of our knowledge, this is the first study to assess the association between hypertension and intestinal barrier integrity in humans
Summary
Previous studies have indicated an association between hypertension and intestinal barrier dysfunction in mice models. The present study aims to investigate the association between hypertension and intestinal barrier impairment in humans and identify the novel potential risk factors for hypertension. The association between the gut and cardiovascular disease has begun to draw our attention in recent years [4, 5]. Intestinal barrier impairment may trigger or exacerbate many diseases including infections, metabolic diseases, and cancer [8,9,10]. Multiple diseases can cause intestinal barrier alterations. The spontaneously hypertensive rat (SHR) model shows obvious alterations in intestinal pathology, including decreased goblet cells and villi length and increased gut permeability and inflammation, suggesting that hypertension led to intestinal barrier impairment [11, 12]
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