A new study published in iMeta sheds light on how angiotensin receptor blockers (ARBs) may ameliorate hypertension by modulating gut microbiota. The research offers a novel perspective on the mechanism of action of ARBs, a widely prescribed class of antihypertensive drugs, potentially explaining individual differences in treatment efficacy.
Gut Microbiota's Role in ARB Efficacy
Li et al.'s research demonstrates that gut microbiota from hypertensive patients receiving ARB treatment can enhance the blood pressure-lowering effect of ARBs. The study used fecal microbiota transplantation (FMT) experiments to directly show this effect. Comprehensive omics analyses, including 16S rRNA sequencing, transcriptomics, and metabolomics, revealed that ARB treatment significantly altered the diversity and composition of gut microbiota, reducing the abundance of Lactobacillus, Aggregatibacter, and Desulfovibrio.
Impact on Circadian Rhythms and Metabolites
The study also found that ARBs might regulate the expression of circadian rhythm-related genes such as Ciart, Per1, Per2, and Per3 by altering gut microbiota. This offers a new explanation for the link between hypertension and circadian rhythm disorders, suggesting ARBs may exert their antihypertensive effects by modulating the host’s physiological rhythms. Metabolomic analysis revealed that ARB treatment significantly reduced serum levels of 6β-hydroxytestosterone and thromboxane B2, providing further clues about the mechanism of action of ARBs.
Limitations and Future Directions
The authors note some limitations of the study, including the small sample size, which may affect the reliability and generalizability of the results. The study also did not validate the specific functions of the identified microorganisms or thoroughly explore the specific molecular mechanisms by which ARBs regulate gut microbiota.
Despite these limitations, the research opens up several promising directions for hypertension treatment. Future research should delve into the specific mechanisms of the gut microbiota-circadian rhythm-blood pressure regulation axis. Targeting the key microbial changes and serum metabolite alterations identified in the study could lead to novel antihypertensive strategies. The finding that gut microbiota from patients with well-controlled hypertension can enhance the effect of ARBs suggests that personalized hypertension treatment plans based on microbiome analysis could optimize ARB treatment efficacy by modulating gut microbiota.
