Analysis Of Gut Microbiota Diversity In People With Different Cardiovascular Risk Stratified Of Hypertension

Background and PurposeHypertension(HTN)is the most common chronic non-communicable disease and a major risk factor for heart failure,myocardial infarction,chronic kidney disease,peripheral vascular disease,and cognitive decline.With the change of lifestyle and the aging of the population,the incidence of global hypertension has increased year by year.It is currently believed that hypertension is the result of multiple factors acting together and superimposing each other,and it's pathogenesis is not yet clear.In recent years,the important role of gut microbiota in human health has become the focus of attention of scholars at home and abroad.More and more evidence reveals that gut microbiota is closely related to hypertension.Intestinal microecological disorders can impair the intestinal mucosal barrier function,leading to endotoxin entering the blood circulation,increasing proinflammatory factors,stimulating inflammatory reactions and other induced hypertension.At the same time,the gut microbiota can regulate the release of metabolites and further affect blood pressure.Previous studies have found that the composition of the gut microbiota in hypertensive patients is significantly different from that in healthy people.The Prevotella and Klebsiella in the patient's intestine are significantly increased,the proportions of Bifidobacterium,Oscillospira and Roseburia are significantly reduced.The feces of hypertensive patients were transplanted into sterile mice by means of fecal transplantation,and the blood pressure of the latter was found to be significantly increased.With the deepening of people's awareness of the role of multiple risk factors of cardiovascular disease and the protection of heart,brain and kidney target organs,the diagnostic criteria of hypertension are also constantly improving.At present,it is considered that blood pressure is not the only factor determining the prognosis of hypertension.The prognosis also includes age,blood glucose,blood lipids and target organ damage.In clinical practice,the cardiovascular risk of hypertension population is divided into low-risk,intermediate-risk,high-risk and very high-risk.Studies have confirmed that cardiovascular risk stratification has a very good predictive value for various cardiovascular disease(CVD)events(myocardial infarction,cardiovascular mortality,total mortality,and major cardiovascular events).Therefore,this study used 16S rDNA high-throughput sequencing technology to explore the changes of gut microbiota in patients with different cardiovascular risk stratified of hypertensive and its predictive value for cardiovascular risk.To provide new targets and new ideas for the prevention and treatment of hypertension.MethodsThis study enrolled 85 patients with essential hypertension,and all individuals were from the Cardiology Department Outpatient and Inpatient Department of Southern Hospital of Southern Medical University.According to the 2018 European Hypertension Guidelines,the patients were divided into low Intermediate-risk group,high-risk group and very high-risk group.The patient's stool samples were collected for 16S rDNA high-throughput sequencing to analyze the change characteristics of gut microbiota in the patients with different cardiovascular risk stratified of hypertension and its predictive value for the risk of cardiovascular events,to further explore the relevant mechanisms of the progression of hypertension.And provide a theoretical basis for reducing the risk of cardiovascular events in hypertension.Results1.The Alpha(a)diversity of gut microbes in hypertensive patients with different cardiovascular risk stratification decreased with the increase of cardiovascular risk(P>0.05).2.There was significant difference in relative abundance of gut microbiota in hypertensive patients with different cardiovascular risk stratification,and the difference was statistically significant(P<0.05).Compared with the low intermediate-risk group,the relative abundances of Roseburia and Anaerostipes were significantly lower in the high-risk group and the very high-risk group,while the relative abundances of Actinomyces,Ruminococcus,Lachnospira,Bilophila and SMB53 in the very high-risk group were significantly lower than those in the high-risk group and the low intermediate-risk group.3.Spearman correlation coefficient analysis showed that the abundance of Klebsiella(r?0.238,P<0.05)and Oscillospira(r=0.243,P<0.05)were positively correlated with Score value,while the abundance of Roseburia(r?-0.385,P<0.001)and Lachnospira(r=-0.491,P<0.01)were negatively correlated with Score value.ConclusionThere are significant differences in the structure and relative abundance of gut microbiota between hypertensive patients with different cardiovascular risk stratification.With the increase of cardiovascular risk,the abundance of probiotics which producing short chain fatty acids decreased significantly,while the abundance of proinflammatory bacteria increased significantly,suggesting that gut microbes may be involved in the development of hypertension.And play an important role in it.This study provides an important basis for further study on the interaction between gut microbiota and risk stratification of hypertension.