Gut microbiome diversity and composition is associated with hypertension in women

<jats:sec> <jats:title>Objectives:</jats:title> <jats:p>Animal studies support a role for the gut microbiota in hypertension development, but large human studies are lacking. Here, we investigated the relationship between hypertension prevalence and gut microbial composition in two cohorts.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We included 871 unrelated TwinsUK women with faecal microbiome data (16s rRNA gene sequencing). Multivariable linear models adjusted for age, age<jats:sup>2</jats:sup> and BMI as well as MiRKAT models, were used to estimate the association of hypertension with alpha- and beta-diversity metrics. To identify taxa associated with hypertension, a generalized additive model for location scale and shape was computed adjusting for covariates and multiple testing. Results were replicated in 448 women from PREDICT-1.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>We found that measures of alpha diversity are significantly lower in hypertensive cases [Beta(95% confidence interval, 95% CI) = −0.05 (−0.095 to −0.004), <jats:italic toggle="yes">P</jats:italic> = 0.03] and a significant association between beta diversity and hypertension (FDR < 0.05). We identified and replicated two genera associated with hypertension. The genus, <jats:italic toggle="yes">Ruminiclostridium 6</jats:italic> was less abundant in hypertension cases [meta-analysis (95% CI) = −0.31 (−0.5 to −0.13), <jats:italic toggle="yes">P</jats:italic> = 1 × 10<jats:sup>−3</jats:sup>]. The uncultured microbe <jats:italic toggle="yes">Erysipelotrichacea-UCG003</jats:italic> was more abundant in hypertensive cases [meta-analysis (95% CI) = 0.46 (0.3–0.62), <jats:italic toggle="yes">P</jats:italic> = 1 × 10<jats:sup>−4</jats:sup>]. We genomically analysed the 16 s rRNA sequence and established a 100% identity match with the 16 s rRNA sequence of the genus <jats:italic toggle="yes">Faecalibacillus.</jats:italic> We functionally annotated <jats:italic toggle="yes">Ruminiclostridium</jats:italic>, identifying 83 metabolic pathways, including pathways previously linked to blood pressure regulation.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>In this large human observation, we show that gut microbiome diversity and composition are associated with hypertension. Our results suggest that targeting the microbiome may be a novel means to prevent or treat hypertension.</jats:p> </jats:sec>