Carnagarin Revathy, Sesa-Ashton Gianni, Ward Natalie C, Nolde Janis, Joyson Anu, Chan Justine, Jose Ancy, Schlaich Markus P
Dobney Hypertension Centre, Medical School, Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Level 3, MRF Building, 50 Rear Murray Street, Perth, WA, 6000, Australia.
Cardiometabolic Health and Exercise Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
Clin Auton Res. 2025 Jul 17. doi: 10.1007/s10286-025-01144-6.
Short-chain fatty acids (SCFAs), metabolites of colonic microflora fermentation of dietary fibre, have been implicated in experimental models and clinical trials to impact blood pressure (BP) regulation. Dietary interventions increasing serum SCFA levels have been associated with reduced 24-h systolic BP in hypertensive patients. However, the underlying mechanisms remain elusive. Given the role of the gut-brain axis and clear evidence for sympathetic nervous system activation as important modulators of blood pressure, we examined the relationship between sympathetic drive and SCFA concentration in patients with resistant hypertension (RH) and healthy control subjects (HC).
A total of 21 patients with RH (68.6 ± 9.7 years, 47% male) and 28 healthy control subjects (HC) (34.6 ± 16.7 years, 75% male) were recruited to undergo microneurography for determination of muscle sympathetic nerve activity (MSNA), automated office BP (AOBP) and blood collection for serum SCFA.
Mean systolic AOBP was 156 ± 21 mmHg and 115 ± 10 mmHg for RH and HC, respectively (p < 0.0001). Serum acetate levels were 1340 ± 115.4 umol/L for HC and 724.5 ± 116.9 umol/L for RH (p < 0.0001). Butyrate and propionate concentrations did not significantly differ between groups. MSNA burst frequency was markedly elevated in RH compared with HCs (p < 0.001), with 25.3 ± 7.4 burst/minute in HC compared with 40.24 ± 8.3 burst/minute in RH. An inverse relationship was evident between serum acetate levels and MSNA burst frequency (p = 0.0267, R = 0.4) along with increased sympathetic vascular transduction (p = 0.0008, R = 0.82) in RH.
Our findings suggest that the beneficial effects of SCFA levels, in particular acetate, on cardiovascular regulation may at least in part be mediated by sympatho-inhibition and altered sympathetic vascular transduction.
短链脂肪酸（SCFAs）是膳食纤维结肠微生物发酵的代谢产物，在实验模型和临床试验中已被证明与血压（BP）调节有关。增加血清SCFA水平的饮食干预与高血压患者24小时收缩压降低有关。然而，其潜在机制仍不清楚。鉴于肠-脑轴的作用以及交感神经系统激活作为血压重要调节因子的明确证据，我们研究了顽固性高血压（RH）患者和健康对照者（HC）交感神经驱动与SCFA浓度之间的关系。
共招募了21例RH患者（68.6±9.7岁，47%为男性）和28例健康对照者（HC）（34.6±16.7岁，75%为男性），进行微神经ography以测定肌肉交感神经活动（MSNA）、自动诊室血压（AOBP）并采集血液测定血清SCFA。
RH组和HC组的平均收缩期AOBP分别为156±21mmHg和115±10mmHg（p<0.0001）。HC组血清乙酸盐水平为1340±115.4μmol/L，RH组为724.5±116.9μmol/L（p<0.0001）。丁酸和丙酸浓度在两组之间无显著差异。与HC相比，RH组的MSNA爆发频率明显升高（p<0.001），HC组为25.3±7.4次/分钟，RH组为40.24±8.3次/分钟。在RH组中，血清乙酸盐水平与MSNA爆发频率之间存在明显的负相关（p=0.0267，R=0.4），同时交感神经血管传导增加（p=0.0008，R=0.82）。
我们的研究结果表明，SCFA水平，尤其是乙酸盐，对心血管调节的有益作用可能至少部分是通过交感神经抑制和交感神经血管传导改变介导的。
