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      Is the Oral Microbiome Associated with Blood Pressure in Older Women?

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          Abstract

          A possible role of the oral microbiome, specifically oral nitrate reducing flora, in blood pressure (BP) homeostasis, if proven etiologic in nature, could lead to novel mechanism-based therapy to improve hypertension prevention and control. This cross-sectional study characterized and compared the oral microbiome between four study groups based on BP status among 446 postmenopausal women aged 53-82 years. Three study groups were not taking hypertension medication and were separated based on BP, as follows: normal BP (systolic <120 and diastolic <80; N=179), elevated BP/Stage I hypertension (systolic 120-139 or diastolic 80-90; N=106), Stage II hypertension (systolic > 140 or diastolic > 90; N=42). The forth group consisted of anyone taking hypertension medications, regardless of BP (N=119). Subgingival microbiome composition was determined using 16S rRNA sequencing with the Illumina MiSeq platform. Kruskal-Wallis tests were used to compare species-level relative abundance of bacterial operational taxonomic units across the four groups. Sixty-five bacterial species demonstrated significant differences in relative abundance in women with elevated BP or using hypertension medication as compared to those with normal BP. After correction for multiple testing, two species, Prevotella oral (species 317) and Streptococcus oralis , remained significant and were lower in abundance among women taking antihypertension medications compared to those with normal BP (corrected P <.05). These data provide novel description of oral subgingival bacteria grouped according to BP status. Additional larger studies including functional analysis and prospective designs will help further assess the potential role of the oral microbiome in BP regulation and hypertension.

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          Most cited references23

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              Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis.

              Diets including food products rich in inorganic nitrate are associated with lower blood pressure (BP). The evidence for the BP-lowering effects of inorganic nitrate and beetroot in randomized clinical trials has not been systematically assessed. The objective was to conduct a systematic review and meta-analysis of randomized clinical trials that examined the effects of inorganic nitrate and beetroot supplementation on BP. Medline, EMBASE, and Scopus databases were searched from inception to February 2013. The specific inclusion criteria were: 1) randomized clinical trials; 2) trials reporting effects on systolic or diastolic BP or both; and 3) trials comparing inorganic nitrate or beetroot juice supplementation with placebo control groups. Random-effects models were used to assess the pooled BP effect sizes. Sixteen trials met the eligibility criteria for the systematic review. All studies had a crossover study design. The trials were conducted between 2006 and 2012 and included a total of 254 participants with 7-30 participants/study. The duration of each intervention ranged from 2 h to 15 d. Inorganic nitrate and beetroot juice consumption were associated with greater changes in systolic BP [-4.4 mm Hg (95% CI: -5.9, -2.8); P < 0.001] than diastolic BP [-1.1 mm Hg (95% CI: -2.2, 0.1); P = 0.06]. The meta-regression showed an association between daily dose of inorganic nitrate and changes in systolic BP (P < 0.05). Inorganic nitrate and beetroot juice supplementation was associated with a significant reduction in systolic BP. These findings need to be tested in long-term trials and in individuals at greater cardiovascular risk.
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                Author and article information

                Journal
                High Blood Pressure & Cardiovascular Prevention
                High Blood Press Cardiovasc Prev
                Springer Science and Business Media LLC
                1120-9879
                1179-1985
                June 2019
                June 24 2019
                June 2019
                : 26
                : 3
                : 217-225
                Article
                10.1007/s40292-019-00322-8
                6610722
                31236901
                53d87f9d-4668-4984-a8d3-716e80f89851
                © 2019

                http://www.springer.com/tdm

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