The association between the gut microbiome and 24-h blood pressure measurements in the SCAPIS study

Abstract

Background: There is mounting evidence supporting the role of the microbiota in hypertension from experimental studies and population-based studies. We aimed to investigate the relationship between specific characteristics of the gut microbiome and 24-h ambulatory blood pressure measurements.

Methods: The association of gut microbial species and microbial functions, determined by shotgun metagenomic sequencing of fecal samples, with 24-h ambulatory blood pressure measurements in 3695 participants and office blood pressure was assessed in multivariable-adjusted models in 2770 participants without antihypertensive medication from the Swedish CArdioPulmonary bioImage Study.

Results: Gut microbiome alpha diversity was negatively associated with diastolic blood pressure variability. Additionally, four microbial species were associated with at least one of the 24-h blood pressure traits. Streptococcus sp001556435 was associated with higher systolic blood pressure, Intestinimonas massiliensis and Dysosmobacter sp001916835 with lower systolic blood pressure, Dysosmobacter sp001916835 with lower diastolic blood pressure, and ER4 sp900317525 with lower systolic blood pressure variability. Moreover, office blood pressure data from a subsample without ambulatory blood pressure measurements replicated the association of Intestinimonas massiliensis with systolic blood pressure and Dysosmobacter sp001916835 with diastolic blood pressure. Species associated with 24-h blood pressure were linked to a similar pattern of metabolites.

Conclusions: In this large cross-sectional analysis, gut microbiome alpha diversity negatively associates with diastolic blood pressure variability, and four gut microbial species associate with 24-h blood pressure traits.

Fig. 1. Association between metagenomic species and 24-h blood pressure traits.

Association between metagenomic species and 24-h blood pressure measurements and their variability from multivariable regression analyses in 3695 individuals from the SCAPIS study is shown. In Model 1, adjustment was made for age, sex, country of birth, technical variation, smoking, fiber intake, total energy intake, estimated sodium intake, use of antidiabetic medication, use of antihyperlipidemic medication, and body mass index. Model 2 was adjusted for Model 1 covariates except BMI. Y-axis shows the species name, and the internal identification number (hMGS.number) in parentheses. The prevalence of the metagenomic species in all samples is presented. The color scale ranges from −1 (dark blue, indicating higher negative correlation) to 1 (dark red, indicating higher positive correlation), with white representing no correlation (0). Abbreviations: SBP 24-h systolic blood pressure, DBP 24-h diastolic blood pressure, SBP-SD variability of 24-h SBP, DBP-SD variability of 24-h DBP. ** indicates associations with FDR < 5%, while * indicates associations with P value < 0.05.

Fig. 2. Forest plot of the association between species and blood pressure in two subsamples.

Associations between species and the ambulatory blood pressure monitoring (ABPM) (24-h blood pressure (BP), n = 3695) and non-ABPM (office BP, n = 2770) subsamples are shown. Model 1 was adjusted for age, sex, country of birth, technical variation, smoking, fiber intake, total energy intake, sodium intake, usage of antidiabetic medications, usage of antihyperlipidemic medications, and body mass index. Each point represents the model coefficient along with the 95% confidence interval. Abbreviations: SBP systolic blood pressure, DBP diastolic blood pressure. N.S. referred to the non-significant associations between species and BP in Model 1.