Gut microbiota composition and blood pressure: The CARDIA study

Shan Sun, Anju Lulla, Michael Sioda, Kathryn Winglee, Michael C. Wu, David R. Jacobs, James M. Shikany, Donald M. Lloyd-Jones, Lenore J. Launer, Anthony A. Fodor, Katie A. Meyer

Research output: Contribution to journalArticlepeer-review

133 Scopus citations


Animal models support a role for the gut microbiota in the development of hypertension. There has been a lack of epidemiological cohort studies to confirm these findings in human populations. We examined cross-sectional associations between measures of gut microbial diversity and taxonomic composition and blood pressure (BP) in 529 participants of the biracial (black and white) CARDIA study (Coronary Artery Risk Development in Young Adults). We sequenced V3-V4 regions of the 16S ribosomal RNA marker gene using DNA extracted from stool samples collected at CARDIA's Year 30 follow-up examination (2015-2016; aged 48-60 years). We quantified associations between BP (hypertension [defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or antihypertension medication use] and systolic BP) and within and between-person diversity measures. We conducted genera-specific multivariable-adjusted regression analysis, accounting for multiple comparisons using the false discovery rate. Hypertension and systolic BP were inversely associated with measures of α-diversity, including richness and the Shannon Diversity Index, and were distinguished with respect to principal coordinates based on a similarity matrix of genera abundance. Several specific genera were significantly associated with hypertension and systolic BP, though results were attenuated with adjustment for body mass index. Our findings support associations between within-person and between-person gut microbial community diversity and taxonomic composition and BP in a diverse population-based cohort of middle-aged adults. Future study is needed to define functional pathways that underlie observed associations and identify specific microbial targets for intervention.

Original languageEnglish (US)
Pages (from-to)998-1006
Number of pages9
Issue number5
StatePublished - May 1 2019

Bibliographical note

Funding Information:
The CARDIA study (Coronary Artery Risk Development in Young Adults) is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). The microbiome study was funded by K01-HL127159, the Intramural Research Program of the National Institute on Aging, the UNC Nutrition Research Institute, the UNC Office of the Vice Chancellor for Research, P30-DK056350, and UL1TR002489.

Publisher Copyright:
© 2019 American Heart Association, Inc.


  • blood pressure
  • epidemiology
  • gastrointestinal microbiome
  • hypertension
  • population


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