The Gut Microbiome of Heart Failure With Preserved Ejection Fraction

Beale, A.; O'Donnell, J.; Nakai, Michael; Nanayakkara, Shane; Vizi, Donna; Carter, K.; Dean, Eliza; Ribiero, Rosilene; Yiallourou, Stephanie; Carrington, M.; Marques, Francine Z.; Kaye, D.

doi:10.1016/j.hlc.2021.06.108

Cited by 12 publications

(15 citation statements)

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“…31,32 Ruminococcus sp. has a lower prevalence in untreated hypertensive 30 and heart failure patients, 33 and is negatively associated with 24-h systolic BP. 30 Similarly, Parabacteroides distasonis is commensal bacteria that metabolises carbohydrates in the colon and mediates local inflammation.…”

Section: Discussionmentioning

confidence: 99%

Gut microbial metabolites lower 24-hour systolic blood pressure in untreated essential hypertensive patients

Jama

Rhys-Jones

Nakai

et al. 2022

Preprint

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BackgroundFibres remain undigested until they reach the colon, where some are fermented by gut microbiota, producing metabolites called short-chain fatty acids (SCFAs). SCFAs lower blood pressure (BP) of experimental models, but their translational potential is unknown. We aimed to determine whether SCFAs lower 24-hour systolic BP (SBP) in untreated participants with essential hypertension.MethodsWe performed a phase II randomized placebo-controlled double-blind cross-over trial using SCFA-supplementation, delivered as acetylated and butyrylated high amylose maize starch (HAMSAB). Twenty treatment-naïve hypertensive participants were recruited from the community and randomised to 40g/day of HAMSAB or placebo. Participants completed each arm for three-weeks, with a three-week washout period between them. The primary endpoint was a 24-hour SBP decrease.ResultsParticipants were on average 55.8±11.2-years old (mean±SD), had a body mass index (BMI) of 25.7±2.5km2/m, 30% were female, baseline 24-hour SBP 136±6mmHg. No adverse effects were reported. After the intervention, the placebo-subtracted reduction in 24-hour SBP was 6.1±9.9mmHg (P= 0.027). This was independent of age, sex, BMI and study arm. There was no statistical significance in the placebo arm. Day and night SBP were reduced by 6.5±12.3mmHg (P=0.01) and 5.7±9.8mmHg (P=0.02), respectively, and 24-h central SBP by 7.2±14.7 mmHg (P=0.005). HAMSAB increased levels of acetate and butyrate by 7.8-fold (P=0.016), shifted the microbial ecosystem, and expanded the prevalence of SCFA-producers.ConclusionsWe observed a clinically relevant reduction in 24-hour SBP in participants with essential hypertension treated with the gut microbial-derived metabolites acetate and butyrate. These metabolites may represent a novel option for lowering BP.

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Section: Discussionmentioning

confidence: 99%

Gut microbial metabolites lower 24-hour systolic blood pressure in untreated essential hypertensive patients

Jama

Rhys-Jones

Nakai

et al. 2022

Preprint

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“…23 The quality of participants’ diet was also measured as the 2013 Australian Dietary Guideline Index 24,25 as described previously. 20,26…”

Section: Methodsmentioning

confidence: 99%

Association Between the Gut Microbiome and Their Metabolites With Human Blood Pressure Variability

et al. 2022

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Background: Blood pressure (BP) variability is an independent risk factor for cardiovascular events. Recent evidence supports a role for the gut microbiota in BP regulation. However, whether the gut microbiome is associated with BP variability is yet to be determined. Here, we aimed to investigate the interplay between the gut microbiome and their metabolites in relation to BP variability. Methods: Ambulatory BP monitoring was performed in 69 participants from Australia (55.1% women; mean±SD, 59.8±7.26 years; body mass index, 25.2±2.83 kg/m 2 ). These data were used to determine nighttime dipping, morning BP surge (MBPS) and BP variability as SD. The gut microbiome was determined by 16S ribosomal RNA (rRNA) sequencing and metabolite levels by gas chromatography. Results: We identified specific taxa associated with systolic BP variability, nighttime dipping, and MBPS. Notably, Alistipesfinegoldii and Lactobacillus spp. were only present in participants within the normal ranges of BP variability, MBPS and dipping, while Prevotella spp. and Clostridium spp., were found to be present in extreme dippers and the highest quartiles of BP SD and MBPS. There was a negative association between MBPS and microbial α-diversity (r=−0.244, P =0.046). MBPS was also negatively associated with plasma levels of microbial metabolites called short-chain fatty acids (r=−0.305, P =0.020), particularly acetate (r=−0.311, P =0.017). Conclusions: Gut microbiome diversity, levels of microbial metabolites, and the bacteria Alistipesfinegoldii and Lactobacillus were associated with lower BP variability and Clostridium and Prevotella with higher BP variability. Thus, our findings suggest the gut microbiome and metabolites may be involved in the regulation of BP variability.

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“…23 The quality of participants’ diet was also measured as Australian Dietary Guideline Index (DGI-2013) 24,25 as described previously. 20,26…”

Section: Methodsmentioning

confidence: 99%

“…23 The quality of participants' diet was also measured as Australian Dietary Guideline Index (DGI-2013) 24,25 as described previously. 20,26 Faecal DNA extraction, library preparation and sequencing This study followed guidelines for gut microbiota studies in hypertension 27 and the Strengthening the Organization and Reporting of Microbiome Studies (STORMS) reporting 28 (checklist available at 20 ). Sample collection, DNA extraction, library preparation and sequencing were described in detail previously.…”

Section: Food Frequency Questionnairementioning

confidence: 99%

The Gut Microbiome and their Metabolites in Human Blood Pressure Variability

Dinakis

Nakai

Gill

et al. 2022

Preprint

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Blood pressure (BP) variability is an independent risk factor for cardiovascular events. Recent evidence supports a role for the gut microbiota in BP regulation. However, whether the gut microbiome is associated with BP variability is yet to be determined. Here, we aimed to investigate the interplay between the gut microbiome and their metabolites in relation to BP variability. Ambulatory BP monitoring was performed in 69 participants from Australia (55.1% women; mean±SD 59.8±7.26-years old, 25.2±2.83 kg/m2). This data was used to determine night-time dipping, morning BP surge (MBPS) and BP variability as standard deviation (SD). The gut microbiome was determined by 16S rRNA sequencing, and metabolite levels by gas chromatography. We identified specific taxa associated with systolic BP variability, night-time dipping and MBPS. Notably, Alistipesfinegoldii and Lactobacillus spp. were only present in participants within the normal ranges of BP variability, MBPS and dipping, while Prevotella spp. and various Clostridium spp. were found to be present in extreme dippers and the highest quartiles of BP SD and MBPS. There was a negative association between MBPS and microbial α-diversity (r=-0.244, P=0.046). MBPS was also negatively associated with total levels of microbial metabolites called short-chain fatty acids (SCFAs) in the plasma (r=-0.305, P=0.020), particularly acetate (r=-0.311, P=0.017). In conclusion, gut microbiome diversity, levels of microbial metabolites, and the bacteria Alistipesfinegoldii and Lactobacillus were associated with lower BP variability, and Clostridium and Prevotella with higher BP variability. Thus, our findings suggest the gut microbiome and metabolites may be involved in the regulation of BP variability.

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The Gut Microbiome of Heart Failure With Preserved Ejection Fraction

Cited by 12 publications

References 0 publications

Gut microbial metabolites lower 24-hour systolic blood pressure in untreated essential hypertensive patients

Gut microbial metabolites lower 24-hour systolic blood pressure in untreated essential hypertensive patients

Association Between the Gut Microbiome and Their Metabolites With Human Blood Pressure Variability

The Gut Microbiome and their Metabolites in Human Blood Pressure Variability

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