The role and mechanisms of gut microbiota in blood pressure regulation and cardiovascular health in hypertensive patients: an intervention study based on probiotics and high-fiber diets

Purpose This study aimed to investigate the effects and mechanisms of probiotics combined with a high-fiber diet (PHFD) on blood pressure regulation and cardiovascular health in hypertensive patients. Methods A retrospective cohort study was conducted involving 322 hypertensive patients admitted between January 2020 and June 2023. Patients were defined into two groups: conventional treatment ( n = 186) and PHFD intervention ( n = 136). The PHFD group received Bifidobacterium Triple Viable Capsules and a personalized high-fiber diet plan for three months. Data collected included demographic characteristics, blood pressure measurements, blood rheology indices, vascular endothelial function markers, inflammatory cytokine levels, gut microbiota composition, and SCFA concentrations. Blood samples and fecal samples were analyzed using biochemical assays, ELISA kits, automated biochemical analyzers, and advanced sequencing techniques. Results After the intervention, the PHFD group showed significantly lower systolic BP ( P = 0.006) and diastolic BP ( P = 0.004) compared to the conventional group. The PHFD group also demonstrated a better therapeutic efficacy ( P = 0.006). Significant improvements were observed in the PHFD group for erythrocyte aggregation index ( P = 0.005), plasma fibrinogen levels ( P = 0.010), ET-1 levels ( P = 0.020), SOD levels ( P = 0.045), and IL-6 levels ( P = 0.014). Gut microbiota analysis revealed significant increases in beneficial bacterial families (Ruminococcaceae, Bifidobacteriaceae) and higher SCFA concentrations (acetate, propionate, butyrate) in the PHFD group (all P < 0.05). Conclusion Probiotics and high-fiber diet interventions effectively modulate gut microbiota and SCFAs, resulting in significant improvements in blood pressure and cardiovascular health among hypertensive patients. These findings highlight the potential of integrated gut microbiota-targeted therapies as novel strategies for hypertension management.