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The Gut & Cardiovascular Health

There is a bi-directional relationship between the health of the gut and microbiome and many factors that influence cardiovascular health. In this article, Dr Cliff Harvey explores the reviews of this topic.

Key points

  • The bi-directional relationship between the gut microbiota and inflammation, sleep, satiety, and ad libitum food intake make a compelling case for the gut having a large impact on cardiovascular health
  • Reduced microbial diversity is associated with increased inflammation
  • Probiotic supplementation can decrease key markers of heart disease like blood pressure,  LDL cholesterol, total cholesterol, and triglycerides
  • Probiotic and synbiotic supplements can also reduce endotoxins that cause systemic inflammation and play a role in the development of heart disease

The microbiome and gut health are linked to many of the systemic factors associated with cardiovascular disease, including the bi-directional relationships between the health of the gut and inflammation, stress, sleep, and obesity and metabolic disorder. So, improving the health of the gut and modulating the intestinal microbiota could play a role in cardiovascular disease prevention.1

In particular, the interplay between the gut, obesity, and inflammation are likely to play a key role in cardiovascular disease. In a systematic review of 14 studies lower gut microbial diversity was associated with higher white blood cell counts and high sensitivity c‐reactive protein levels (a measure of systemic inflammation).

The interplay between the gut, obesity, and inflammation are likely to play a key role in cardiovascular disease

Additionally, Bifidobacterium, Faecalibacterium, Ruminococcus and Prevotella species were associated with lower levels of key inflammatory markers (c-reactive protein and interleukin 6). There are also likely associations between the microbiome and the inflammasome, the innate immune system, bile acids, gut permeability, the endocannabinoid system and TMAO.2

Probiotics and cardiovascular health

Pooled data from 11 randomised controlled trials (n = 641) suggests that probiotic supplementation can decrease key markers of heart disease; blood pressure,  LDL cholesterol, total cholesterol, and triglycerides.3 Probiotic and synbiotic supplements also reduce endotoxins that cause systemic inflammation and play a role in the development of heart disease.4, 5

Randomised controlled trials suggests that probiotic supplementation can decrease key markers of heart disease

References

1.         Tang WHW, Bäckhed F, Landmesser U, Hazen SL. Intestinal Microbiota in Cardiovascular Health and Disease: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2019;73(16):2089-105.

2.         van den Munckhof ICL, Kurilshikov A, ter Horst R, Riksen NP, Joosten LAB, Zhernakova A, et al. Role of gut microbiota in chronic low-grade inflammation as potential driver for atherosclerotic cardiovascular disease: a systematic review of human studies. Obesity Reviews. 2018;19(12):1719-34.

3.         Hendijani F, Akbari V. Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: A systematic review and meta-analysis. Clinical Nutrition. 2018;37(2):532-41.

4.         March DS, Jones AW, Bishop NC, Burton JO. The Efficacy of Prebiotic, Probiotic, and Synbiotic Supplementation in Modulating Gut-Derived Circulatory Particles Associated With Cardiovascular Disease in Individuals Receiving Dialysis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Journal of Renal Nutrition. 2019.

5.         Moludi J, Maleki V, Jafari-Vayghyan H, Vaghef-Mehrabany E, Alizadeh M. Metabolic endotoxemia and cardiovascular disease: A systematic review about potential roles of prebiotics and probiotics. Clinical and Experimental Pharmacology and Physiology. 2020;47(6):927-39.

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