Gut and oral microbiota in patients with arterial hypertension and metabolic syndrome

Abstract

In recent years, the role of intestinal microbiota in the pathogenesis of cardiovascular diseases (CVD) and metabolic syndrome (MS) has attracted attention. There is evidence that intestinal bacterial metabolites contribute to development of atherosclerosis, hypertension, heart failure, obesity, diabetes, and immune disorders. Changes in the intestinal macrobiotic landscape lead to increased intestinal permeability and endotoxemia, which play a role in chronic inflammation and facilitate development of obesity and other MS comorbidities.
Aim. To study features of intestinal and oral microbiota in patients with arterial hypertension (AH) associated with MS.
Methods. Study materials were feces and oral fluid of patients with AH and MS where the microbiome was studied with a classical bacteriological analysis. Microorganisms were identified by their morphological, tinctorial, cultural, and biochemical properties.
Results. In feces of hypertensive patients with MS as distinct from patients with hypertension, incidences of E. coli and Klebsiella spp. were increased; Bacillus spp., Streptococcus spp., Proteus spp., Neisseria spp., and S. aureus were found; incidences of Lactobacillus spp., and Bacteroides spp. were decreased; and Bifidobacterium spp. were absent. In the oral fluid of patients with AH and MS, Clostridium spp., Lactobacillus spp., Klebsiella spp. and small amounts of Neisseria spp. and Fusobacterium spp. were found.
Conclusion. Pronounced dysbacteriosis with predominating opportunistic Klebsiella, enterobacteria, Proteus, and Staphylococcus aureus was observed in the large intestine of hypertensive patients with MS. The intestinal microbiome of patients with AH (without MS) was represented by normal microflora. Conditionally pathogenic Clostridium and Klebsiella also predominated in the oral cavity of patients with hypertension and MS. The microbiota of patients with AH without MS was more diverse with predominating normal flora.