综述

肠道菌群在高血压治疗中的研究进展

  • 黄艺霖 ,
  • 李爽 ,
  • 贺正庸 ,
  • 张泽宇
展开
  • 1.南昌大学创伤医学研究所,创烧伤及疼痛江西省重点实验室,急诊外科,第一附属医院,江西医学院,南昌大学 (江西 南昌 330006 )
    2.焕奎书院,江西医学院,南昌大学 (江西 南昌 330031 )
    3.玛丽女王学院,江西医学院,南昌大学 (江西 南昌 330031 )
    4.第一临床医学院,江西医学院,南昌大学 (江西 南昌 330006 )

收稿日期: 2025-07-09

  网络出版日期: 2025-10-10

基金资助

江西省自然科学基金资助项目(20242BAB20343)

Research progress on fecal microbiota transplantation for the treatment of hypertension

  • Yilin HUANG ,
  • Shuang LI ,
  • Zhengyong HE ,
  • Zeyu. ZHANG
Expand
  • *.Institute of Trauma Medicine,Nanchang University,Jiangxi Provincial Key Laboratory of Wounds,Burns and Pain,Emergency Surgery,First Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang 330006,Jiangxi,China

Received date: 2025-07-09

  Online published: 2025-10-10

摘要

高血压是导致我国心血管疾病发生及过早死亡的重要危险因素。高血压的发病机制复杂并受到多种因素影响。肠道菌群参与调节人体多项生理进程,是人体健康的重要影响因素。有大量研究显示,肠道菌群稳态失衡与高血压发生和发展密切相关,恢复肠道菌群稳态可以降低血压。因此,肠道菌群已成为高血压的潜在治疗靶点。基于此,该文主要对肠道菌群与高血压的关联、调控肠道菌群稳态防治高血压的研究进展作一综述。

本文引用格式

黄艺霖 , 李爽 , 贺正庸 , 张泽宇 . 肠道菌群在高血压治疗中的研究进展[J]. 实用医学杂志, 2025 , 41(19) : 3129 -3134 . DOI: 10.3969/j.issn.1006-5725.2025.19.025

Abstract

Hypertension is an important risk factor that causes cardiovascular diseases and premature death in China. The pathogenesis of hypertension is complex and affected by numerous factors. Gut microbiota are involved in regulating many physiological processes of human body, making it a key factor in human health. Many studies have shown that there are close relationships between gut microbiota dysbiosis and the onset and progression of hypertension. Restoring gut microbiota homeostasis can reduce blood pressure. Thus, gut microbiota has become a potential therapeutic target for hypertension. Therefore, this article mainly reviews the connection between gut microbiota and hypertension, as well as the study progress of adjusting gut microbiota homeostasis for the prevention and treatment of hypertension.

参考文献

[1] 赵冬. 中国成人高血压流行病学现状 [J]. 中国心血管杂志, 2020, 25(6): 513-515.
[2] 曲凤霞, 李婧媛, 郭晓, 等. 互联网+心脏康复对高血压合并冠心病患者干预的疗效 [J]. 实用医学杂志, 2024, 40(19): 2778-2782.
[3] WANG Z, CHEN Z, ZHANG L, et al. Status of Hypertension in China: Results From the China Hypertension Survey, 2012-2015 [J]. Circulation, 2018, 137(22): 2344-2356. doi:10.1161/circulationaha.117.032380
[4] 国家心血管病中心,中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2023概要 [J]. 中国循环杂志, 2024, 39(7): 625-660.
[5] 李立明, 饶克勤, 孔灵芝, 等. 中国居民营养与健康状况调查技术执行组. 中国居民2002年营养与健康状况调查 [J]. 中华流行病学杂志, 2005, 26(7): 478-84.
[6] MA J, CHEN X. Advances in pathogenesis and treatment of essential hypertension [J]. Front Cardiovasc Med, 2022, 9: 1003852. doi:10.3389/fcvm.2022.1003852
[7] LI Y, DENG Q, LIU Z. The relationship between gut microbiota and insomnia: A bi-directional two-sample Mendelian randomization research [J]. Front Cell Infect Microbiol, 2023, 13: 1296417. doi:10.3389/fcimb.2023.1296417
[8] LI J, ZHAO F, WANG Y, et al. Gut microbiota dysbiosis contributes to the development of hypertension [J]. Microbiome, 2017, 5(1): 14. doi:10.1186/s40168-016-0222-x
[9] 毕馨文, 崔远捷, 陆秋娴, 等. 肠道菌群对高脂饮食诱导肥胖小鼠糖脂代谢紊乱的免疫调节作用 [J]. 实用医学杂志, 2024, 40(11): 1505-1512.
[10] YANG T, MAKI K A, MARQUES F Z, et al. Hypertension and the Gut Microbiome: A Science Advisory From the American Heart Association [J]. Hypertension, 2025,82(9):e160-e170. doi:10.1161/hyp.0000000000000247
[11] SHI H, ZHANG B, ABO-HAMZY T, et al. Restructuring the Gut Microbiota by Intermittent Fasting Lowers Blood Pressure [J]. Circ Res, 2021, 128(9): 1240-1254. doi:10.1161/circresaha.120.318155
[12] PAPAKONSTANTINOU E, ZACHARODIMOS N, GEORGIOPOULOS G, et al. Two-Month Consumption of Orange Juice Enriched with Vitamin D3 and Probiotics Decreases Body Weight, Insulin Resistance, Blood Lipids, and Arterial Blood Pressure in High-Cardiometabolic-Risk Patients on a Westernized Type Diet: Results from a Randomized Clinical Trial [J]. Nutrients, 2024, 16(9): 1331. doi:10.3390/nu16091331
[13] LI K, JIANG P, LI S, et al. ACE inhibitory casein peptide lowers blood pressure and reshapes gut microbiota in a randomized double blind placebo controlled trial [J]. Sci Rep, 2025, 15(1): 13840. doi:10.1038/s41598-025-98446-6
[14] PALMU J, SALOSENSAARI A, HAVULINNA A S, et al. Association Between the Gut Microbiota and Blood Pressure in a Population Cohort of 6953 Individuals [J]. J Am Heart Assoc, 2020, 9(15): e016641. doi:10.1161/jaha.120.016641
[15] NAKAI M, RIBEIRO R V, STEVENS B R, et al. Essential Hypertension Is Associated With Changes in Gut Microbial Metabolic Pathways: A Multisite Analysis of Ambulatory Blood Pressure [J]. Hypertension, 2021, 78(3): 804-815. doi:10.1161/hypertensionaha.121.17288
[16] MUSHTAQ N, HUSSAIN S, ZHANG S, et al. Molecular characterization of alterations in the intestinal microbiota of patients with grade 3 hypertension [J]. Int J Mol Med, 2019, 44(2): 513-522.
[17] DINAKIS E, NAKAI M, GILL P, et al. Association Between the Gut Microbiome and Their Metabolites With Human Blood Pressure Variability [J]. Hypertension, 2022, 79(8): 1690-1701. doi:10.1161/hypertensionaha.122.19350
[18] FANG C, ZUO K, FU Y, et al. Aggravated Gut Microbiota and Metabolomic Imbalances Are Associated with Hypertension Patients Comorbid with Atrial Fibrillation [J]. Biomolecules, 2022, 12(10) :1445. doi:10.3390/biom12101445
[19] LIN Y T, SAYOLS-BAIXERAS S, BALDANZI G, et al. The association between the gut microbiome and 24-h blood pressure measurements in the SCAPIS study [J]. Commun Med, 2025, 5(1): 276. doi:10.1038/s43856-025-00980-x
[20] XIONG Y, HE Y, CHEN Z, et al. Lactobacillus induced by irbesartan on spontaneously hypertensive rat contribute to its antihypertensive effect [J]. J Hypertens, 2024, 42(3): 460-470. doi:10.1097/hjh.0000000000003613
[21] YUN F, HAN X, WANG Z, et al. Intermittent fasting ameliorates resistant hypertension through modulation of gut microbiota [J]. Pharmacol Res, 2025: 107864. doi:10.1016/j.phrs.2025.107864
[22] XU X, JIN H, LI X, et al. Fecal Microbiota Transplantation Regulates Blood Pressure by Altering Gut Microbiota Composition and Intestinal Mucosal Barrier Function in Spontaneously Hypertensive Rats [J]. Probiotics Antimicrob Proteins, 2024, 219:107864. doi:10.1007/s12602-024-10344-x
[23] GUO J, JIA P, GU Z, et al. Altered gut microbiota and metabolite profiles provide clues in understanding resistant hypertension [J]. J Hypertens, 2024, 42(7): 1212-1225. doi:10.1097/hjh.0000000000003716
[24] PLUZNICK J L. Microbial Short-Chain Fatty Acids and Blood Pressure Regulation [J]. Curr Hypertens Rep, 2017, 19(4): 25. doi:10.1007/s11906-017-0722-5
[25] SAM Q H, LING H, YEW W S, et al. The Divergent Immunomodulatory Effects of Short Chain Fatty Acids and Medium Chain Fatty Acids [J]. Int J Mol Sci, 2021, 22(12): 6453. doi:10.3390/ijms22126453
[26] TANG W H W, WANG Z, LEVISON B S, et al. Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk [J]. N Engl J Med, 2013, 368(17): 1575-1584. doi:10.1056/nejmoa1109400
[27] JIANG S, SHUI Y, CUI Y, et al. Gut microbiota dependent trimethylamine N-oxide aggravates angiotensin Ⅱ-induced hypertension [J]. Redox Biol, 2021, 46: 102115. doi:10.1016/j.redox.2021.102115
[28] LI W, LIANG P, MA X, et al. The Association Between High-Sensitivity C-Reactive Protein and the Progression of Arteriosclerosis: The Kailuan Study [J]. J Inflamm Res, 2025, 18: 7047-7054. doi:10.2147/jir.s524495
[29] MUKOHDA M, YANO T, MATSUI T, et al. Treatment with Ligilactobacillus murinus lowers blood pressure and intestinal permeability in spontaneously hypertensive rats [J]. Sci Rep, 2023, 13(1): 15197. doi:10.1038/s41598-023-42377-7
[30] EISEMAN B, SILEN W, BASCOM G S, et al. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis [J]. Surgery, 1958, 44(5): 854-859.
[31] TORAL M, ROBLES-VERA I, DE LA VISITACIóN N, et al. Critical Role of the Interaction Gut Microbiota-Sympathetic Nervous System in the Regulation of Blood Pressure [J]. Front Physiol, 2019, 10: 231. doi:10.3389/fphys.2019.00231
[32] XIA W J, XU M L, YU X J, et al. Antihypertensive effects of exercise involve reshaping of gut microbiota and improvement of gut-brain axis in spontaneously hypertensive rat [J]. Gut Microbes, 2021, 13(1): 1-24. doi:10.1080/19490976.2020.1854642
[33] MARQUES F Z, NELSON E, CHU P Y, et al. High-Fiber Diet and Acetate Supplementation Change the Gut Microbiota and Prevent the Development of Hypertension and Heart Failure in Hypertensive Mice [J]. Circulation, 2017, 135(10): 964-977. doi:10.1161/circulationaha.116.024545
[34] ZHONG H J, ZENG H L, CAI Y L, et al. Washed Microbiota Transplantation Lowers Blood Pressure in Patients With Hypertension [J]. Front Cell Infect Microbiol, 2021, 11: 679624. doi:10.3389/fcimb.2021.679624
[35] FAN L, CHEN J, ZHANG Q, et al. Fecal microbiota transplantation for hypertension: An exploratory, multicenter, randomized, blinded, placebo-controlled trial [J]. Microbiome, 2025, 13(1): 133. doi:10.1186/s40168-025-02118-6
[36] ZHANG Y, ZHENG T, MA D, et al. Probiotics Bifidobacterium lactis M8 and Lactobacillus rhamnosus M9 prevent high blood pressure via modulating the gut microbiota composition and host metabolic products [J]. mSystems, 2023, 8(6): e0033123. doi:10.1128/msystems.00331-23
[37] ZHOU T, WANG Z, LV X, et al. Targeting gut S. aureofaciens Tü117 serves as a new potential therapeutic intervention for the prevention and treatment of hypertension [J]. Cell Metab, 2025, 37(2): 496-513.e11. doi:10.1016/j.cmet.2025.01.004
[38] MAIA L A, DE SOUZA J R, SILVA L F R DA, et al. Effects of Probiotics on Inflammatory Biomarkers and Its Associations With Cardiac Autonomic Function in Women With Arterial Hypertension: A Secondary Analysis of a Randomized Clinical Trial [J]. Probiotics Antimicrob Proteins, 2025, 17(4): 1921-1928. doi:10.1007/s12602-024-10303-6
[39] ZHENG L, ZHANG J, YANG J, et al. Association of the use of nonfood prebiotics, probiotics, and synbiotics with total and cause-specific mortality: a prospective cohort study [J]. Nutr J, 2025, 24(1): 45. doi:10.1186/s12937-025-01104-w
[40] JAUHIAINEN T, VAPAATALO H, POUSSA T, et al. Lactobacillus helveticus fermented milk lowers blood pressure in hypertensive subjects in 24-h ambulatory blood pressure measurement [J]. Am J Hypertens, 2005, 18(12 Pt 1): 1600-1605. doi:10.1016/j.amjhyper.2005.06.006
[41] TALADRID D, DE CELIS M, BELDA I, et al. Hypertension- and glycaemia-lowering effects of a grape-pomace-derived seasoning in high-cardiovascular risk and healthy subjects. Interplay with the gut microbiome [J]. Food Funct, 2022, 13(4): 2068-2082. doi:10.1039/d1fo03942c
[42] LI J, CHEN C, YANG H, et al. Tea polyphenols regulate gut microbiota dysbiosis induced by antibiotic in mice [J]. Food Res Int, 2021, 141: 110153. doi:10.1016/j.foodres.2021.110153
[43] KIRSCHNER S K, ENGELEN M P K J, HAAS P, et al. Short-chain fatty acid kinetics and concentrations are higher after inulin supplementation in young and older adults: A randomized trial [J]. Am J Clin Nutr, 2025, 121(6): 1224-1235. doi:10.1016/j.ajcnut.2025.04.018
[44] XUE Y, CUI L, QI J, et al. The effect of dietary fiber (oat bran) supplement on blood pressure in patients with essential hypertension: A randomized controlled trial [J]. Nutr Metab Cardiovasc Dis, 2021, 31(8): 2458-2470. doi:10.1016/j.numecd.2021.04.013
[45] JAMA H A, RHYS-JONES D, NAKAI M, et al. Prebiotic intervention with HAMSAB in untreated essential hypertensive patients assessed in a phase II randomized trial [J]. Nat Cardiovasc Res, 2023, 2(1): 35-43. doi:10.1038/s44161-022-00197-4
[46] FILIPPOU C, THOMOPOULOS C, KONSTANTINIDIS D, et al. DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial [J]. Clin Nutr, 2023, 42(10): 1807-1816. doi:10.1016/j.clnu.2023.08.011
[47] RINOTT E, MEIR A Y, TSABAN G, et al. The effects of the Green-Mediterranean diet on cardiometabolic health are linked to gut microbiome modifications: A randomized controlled trial [J]. Genome Med, 2022, 14(1): 29. doi:10.1186/s13073-022-01015-z
[48] SACKS F M, SVETKEY L P, VOLLMER W M, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group [J]. N Engl J Med, 2001, 344(1): 3-10.
[49] CHEN L, HE F J, DONG Y, et al. Modest Sodium Reduction Increases Circulating Short-Chain Fatty Acids in Untreated Hypertensives: A Randomized, Double-Blind, Placebo-Controlled Trial [J]. Hypertension, 2020, 76(1): 73-79. doi:10.1161/hypertensionaha.120.14800
[50] MU L, YU P, XU H, et al. Effect of sodium reduction based on the DASH diet on blood pressure in hypertensive patients with type 2 diabetes [J]. Nutr Hosp, 2022, 39(3): 537-546.
[51] PEPINE C J, THIEL A, KIM S, et al. Potential of Minocycline for Treatment of Resistant Hypertension [J]. Am J Cardiol, 2021, 156: 147-149. doi:10.1016/j.amjcard.2021.07.004
[52] GALLA S, CHAKRABORTY S, CHENG X, et al. Disparate effects of antibiotics on hypertension [J]. Physiol Genomics, 2018, 50(10): 837-845. doi:10.1152/physiolgenomics.00073.2018
[53] YANG T, SANTISTEBAN M M, RODRIGUEZ V, et al. Gut dysbiosis is linked to hypertension [J]. Hypertension, 2015, 65(6): 1331-1340. doi:10.1161/hypertensionaha.115.05315
[54] GALLA S, CHAKRABORTY S, CHENG X, et al. Exposure to Amoxicillin in Early Life Is Associated With Changes in Gut Microbiota and Reduction in Blood Pressure: Findings From a Study on Rat Dams and Offspring [J]. J Am Heart Assoc, 2020, 9(2): e014373. doi:10.1161/jaha.119.014373
[55] LI X, BREJNROD A, THORSEN J, et al. Differential responses of the gut microbiome and resistome to antibiotic exposures in infants and adults [J]. Nat Commun, 2023, 14(1): 8526. doi:10.1038/s41467-023-44289-6
文章导航

/