Specific Alterations of Gut Microbiota in Chinese Patients with Hypertension: A Systematic Review and Meta-Analysis

Abstract

Background: China has the largest absolute burden of hypertension (HTN) in the world. Gut dysbiosis may be a potentially modifiable risk factor for HTN. However, the characteristics of gut microbiota in Chinese populations with HTN remain to be determined. Methods: We systematically searched for studies comparing the gut microbial in HTN with healthy controls in databases. The cut-off date was December 30, 2021. Semiquantitative analysis and meta-analysis with standardized mean differences of the alteration in gut microbiota were carried out. Results: A total of 16 studies involving 2372 patients with HTN and 849 controls were included, covering 16 Chinese provinces or regions. The present study supports that compared to healthy population, the diversity of patients with HTN is significantly compromised, while richness is overall preserved. To be specific, a significant increase of the Firmicutes(F)/Bacteroidetes(B) ratio is considered as a special parameter of gut microbiota in HTN patients. The increased abundance of phylum Firmicutes, genus Megasphaera, Escherichia_Shigella, and Klebsiella, while the lower abundance of phylum Bacteroidetes, genus Bifidobacterium, Faecalibacterium, Roseburia, and Ruminococcus may be associated with HTN. The gut microbial metabolism in HTN was more abundant in LPS biosynthesis, membrane transport, and steroid degradation. Conclusions: Variation in gut microbial parameters is likely associated with Chinese patients with HTN. Further investigations should distinguish geographical and ethnic characteristics to develop in-depth knowledge of the underlying mechanisms by which gut dysbiosis contributes to HTN.

Gut microbiota changes in patients with hypertension: A systematic review and meta‐analysis

“…In this study, the Shannon index of hypertensive patients decreased significantly, which was partially consistent with the results of Yang and coworkers 47 The difference was that there was no significant difference in Chao1 index between HTN and HC in this study. This result suggested that although the diversity of GM in hypertensive patients had been damaged to some extent, the richness had been retained as a whole 21 . In addition, we also found that there was a negative correlation between the Shannon index and HTN, which was consistent with the reported significant decrease in the Shannon index of GM in hypertensive patients in this study.…”

“…It is worth noting that although this study conducted meta‐analysis on gut microbial diversity indicators such as Shannon, Simpson, Chao1, ACE, the relative abundance of microbial groups was only semi‐quantitatively analyzed, and no combined analysis was conducted on them. In addition, due to the insufficient measurement depth and differences in measurement methods of the microbiome in the included studies, there was still no clear evidence to identify pathogenic bacteria closely related to HTN 21 …”

“…In addition, due to the insufficient measurement depth and differences in measurement methods of the microbiome in the included studies, there was still no clear evidence to identify pathogenic bacteria closely related to HTN. 21 The gut microbiome's complexity can be quantified and unraveled using high-throughput sequencing techniques, which also known as next-generation sequencing. 13 With the rapid development of highthroughput sequencing techniques and the smooth progress of deep sequencing, the importance of GM has been better recognized.…”

Characteristic Gut Bacteria in High Barley Consuming Japanese Individuals without Hypertension

“…Moreover, a previous study on animals reported that a fecal microbiota transplant from hypertensive mice into germ-free mice resulted in the animals developing hypertension [ 37 ]. In addition, several studies have reported an association between hypertension and dysbiosis, indicating that the intestinal bacterial equilibrium plays an important role in the development of hypertension and in blood pressure control [ 38 , 39 ]. Consistent with the findings of these studies, the non-responders in this study tended to have a lower Shannon index, which was calculated based on the proportion of species in a gut microbiome.…”

Research Progress on the Correlation Between Hypertension and Gut Microbiota

“…In a healthy intestinal ecosystem, Bacteroidetes and Firmicutes are the dominant bacterial groups, and thus, the Firmicutes/Bacteroidetes (F/B) ratio can be regarded as a potential biomarker for pathological states. 13 A study based on high-throughput sequencing technology using fecal samples from patients with grade 3 hypertension and healthy controls revealed that the gut microbiota of hypertensive patients exhibited significant decreases in abundance, diversity, and uniformity, with a notable increase in the F/B ratio. This increase was accompanied by an elevation in the abundance of Prevotella_9, Megasphaera, Parasutterella, and Escherichia Shigella, while the abundance of Bacteroides and Faecalibacterium decreased.…”