Prospective association between the gut microbiome and incident hypertension: a 20-year cohort study.

Overall gut microbiome composition was not associated with risk of future hypertension in multivariable-adjusted models.

• Study sample consisted of 3311 nonhypertensive individuals (60.7% women) aged 25-74 years drawn from the general population in Finland.
• Baseline examination was performed in 2002 with stool sample collection and health examination.
• Gut microbiome was assessed using shallow shotgun metagenomic sequencing.
• Microbiome analyses were performed with Cox proportional hazards model.
• In total, 675 participants developed hypertension over a follow-up period of nearly 20 years.

Eight genera were significantly associated with incident hypertension in age-adjusted and sex-adjusted models, but none remained significant after multivariable adjustment.

• The eight genera were Agathobaculum, Blautia_A_141780, Blautia_A_141781, Mediterraneibacter_A_155590, Enterocloster, Bariatricus, CAG-317-146760, and CAG-628.
• Significance of these genera was attenuated after adjusting for covariates known to influence the gut microbiome.
• Associations were identified in age-adjusted and sex-adjusted models but did not survive multivariable adjustment.

No functional pathways were associated with hypertension risk.

• Functional pathway analysis was conducted as part of the microbiome analyses.
• No functional pathways reached significance in association with incident hypertension.
• This finding was consistent with the lack of significant compositional associations in multivariable-adjusted models.

The study assessed the gut microbiome in a large population-based cohort with a follow-up period of nearly 20 years.

• Participants were drawn from the general population in Finland.
• The cohort included 3311 nonhypertensive individuals at baseline in 2002.
• Follow-up extended for nearly 20 years, during which 675 participants developed hypertension.
• Shallow shotgun metagenomic sequencing was used to assess the gut microbiome.