Department of Cardiology, the First Hospital of China Medical University, Shenyang.
Department of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
J Hypertens. 2024 Jul 1;42(7):1212-1225. doi: 10.1097/HJH.0000000000003716. Epub 2024 Mar 8.
Resistant hypertension is a severe phenotype in hypertension that may be driven by interactions between genetic and environmental factors. Specific changes in gut microbiota and metabolites have been shown to influence cardiovascular disease progression. However, microbial and metabolomic changes associated with resistant hypertension remain elusive.
In this study, the gut microbiome of 30 participants with resistant hypertension, 30 with controlled hypertension, and 30 nonhypertension was characterized using 16S rRNA amplicon sequencing. In addition, the serum metabolome of the same population was assessed by untargeted metabolomics.
The alpha diversity of microbiome in the resistant hypertension decreased, and changes were also observed in the composition of the gut microbiota. The resistant hypertension group was characterized by elevated levels of Actinobacteitia and Proteobacteria. Twenty-three genera were found to have significantly different abundances between resistant hypertension and controlled hypertension, as well as 55 genera with significantly different abundances between resistant hypertension and nonhypertension. Compared with the controlled hypertension group, the genera Rothia and Sharpea in resistant hypertension were more abundant. Compared with the nonhypertension group, the genera Escherichia-Shigella , Lactobacillus , Enterococcus were more abundant. Untargeted metabolomics provided distinctly different serum metabolic profiles for the three groups and identified a range of differential metabolites. These metabolites were mainly associated with the pathway of glycerophospholipid metabolism. Furthermore, correlation analysis provided evidence of new interactions between gut microbiota and metabolites in the resistant hypertension.
In conclusion, our study provides a comprehensive understanding of the resistant hypertension gut microbiota and metabolites, suggesting that treatment resistance in resistant hypertension patients may be related to the gut microbiota and serum metabolites.
高血压是一种严重的疾病表型，可能由遗传和环境因素相互作用驱动。肠道微生物群和代谢物的特定变化已被证明会影响心血管疾病的进展。然而，与耐药性高血压相关的微生物和代谢组学变化仍不清楚。
本研究采用 16S rRNA 扩增子测序技术，对 30 名耐药性高血压患者、30 名血压控制良好的高血压患者和 30 名非高血压患者的肠道微生物群进行了特征分析。此外，还通过非靶向代谢组学评估了相同人群的血清代谢组。
耐药性高血压患者肠道微生物组的 alpha 多样性降低，肠道微生物群的组成也发生了变化。耐药性高血压组的放线菌和变形菌丰度升高。在耐药性高血压与血压控制良好的高血压之间，有 23 个属的丰度存在显著差异，在耐药性高血压与非高血压之间，有 55 个属的丰度存在显著差异。与血压控制良好的高血压组相比，耐药性高血压组的罗特氏菌属和沙雷氏菌属更为丰富。与非高血压组相比，耐药性高血压组的埃希氏菌-志贺氏菌属、乳杆菌属和肠球菌属更为丰富。非靶向代谢组学为三组提供了明显不同的血清代谢特征，并鉴定了一系列差异代谢物。这些代谢物主要与甘油磷脂代谢途径有关。此外，相关性分析为耐药性高血压患者肠道微生物群和代谢物之间的新相互作用提供了证据。
综上所述，本研究全面了解了耐药性高血压的肠道微生物群和代谢物，提示耐药性高血压患者的治疗抵抗可能与肠道微生物群和血清代谢物有关。
