We have abundant knowledge of how traditional risk factors contribute to cardiovascular diseases, such as high cholesterol, smoking, and a sedentary lifestyle. However, recent scientific literature has shed light on the gut-heart connection, making gut microbiology a promising new target for improving cardiovascular health.
Good gut health is essential for a healthy heart. Findings from studies in rodents, animals, and humans have established the contribution of the gut microbiome to a wide array of diseases and cardiovascular risk. The gut microbes form various byproducts, which upon entering the bloodstream have wide-reaching systemic effects.
Some of these activate receptors on blood vessels that cause the lowering of blood pressure. Existing literature reports that individuals with high blood pressure have a disrupted gut microbiota, emphasizing the importance of digestive health. Additionally, bacteria and bacterial DNA signatures detected in atherosclerotic plaques have been linked to the oral cavity and gut of the same person, indicating that gut bacteria may influence plaque stability and the development of heart disease.
Studies in rats show that the gut microbiome can determine the severity of heart attack, as well. A disrupted gut microbiome composition has also been associated with obesity and type II diabetes, both of which are heart disease risk factors.
Remember, the human body is colonized by a vast population of microorganisms, which play an important role in regulating bodily processes. These microbes prefer to reside in the gut as it has a low-oxygen and nutrient-rich environment. The gut bacteria participate in physiological functions such as the breakdown of sugars and the production of fatty acids.
However, their interaction with the host is not limited to supporting food metabolism––they are also involved in the maturation of immune cells and the maintenance of intestinal barriers. Due to their multifaceted role within the body, they are fundamental to human health.
In Small Intestinal Bacterial Overgrowth (SIBO), there is an abnormal increase in the population of gut bacteria. This occurs as a consequence of surgery or disease, which slows down the passage of food/waste through the gut and allows bacteria to flourish. According to a 2018 study, individuals with SIBO have an 80% higher risk of coronary artery disease (CAD).
SIBO is prevalent among heart failure patients and is linked to adverse health outcomes in this population. It is associated with an increased risk of rehospitalization and cardiac death in heart failure patients. SIBO also results in excessive production of the gut bacteria metabolite TMAO, which causes inflammation in the coronary arteries.
A leaky gut can cause a chronic inflammatory state by allowing bacterial products such as lipopolysaccharide (LPS) endotoxins into the bloodstream. Prolonged inflammation is a risk factor for heart disease. Such a state can contribute to the worsening of heart failure and atherosclerosis. Due to higher gut permeability, patients with inflammatory bowel diseases (IBDs) have a higher risk of developing heart disease.
Dietary supplements such as probiotics and prebiotics can be used to maintain a healthy gut microbiome. Probiotics are beneficial bacteria, while prebiotics are substances that aid the growth of healthy bacteria in the gut.
Multiple studies have shown that both probiotics and prebiotics reduce blood pressure. The underlying mechanisms include lowering of fat content (LDL cholesterol and triglycerides), regulation of glucose levels, and improvement in insulin sensitivity. Prebiotics also promote the conversion of fibers to short-chain fatty acids, which lower blood pressure. Furthermore, probiotics produce anti-hypertensive peptides that play a role in decreasing blood pressure.
Short-chain fatty acids are end products derived from the bacterial fermentation of dietary fibers within the gut, where they maintain the integrity of the gastrointestinal tract lining. They also regulate the risk of cardiovascular disease as they reduce blood pressure, suppress insulin-mediated fat accumulation, and regulate glucose homeostasis.
Sugar is the main nutrient source for gut bacteria, and an increased intake is likely to cause alteration in the gut microbiome and an increased risk for heart disease.
NSAIDs such as aspirin erode and perforate the intestinal epithelium, which can result in a leaky gut. They also cause the intestinal cells to reduce mucosal secretion, which is needed by the bacterial colonies to adhere to the intestinal lining. Subsequently, non-adhering gut bacteria are lost in the feces and the gut microbial environment is disrupted.
Exposure to antibiotics can alter the diversity of the gut microbial communities, affect host immunity, and increase the risk for cardiometabolic diseases. They do collateral damage to good bacteria, causing a reduction of bacterial metabolites that promote heart health. With that, it's wise to be conservative with the use of antibiotics.
Exercise directly and indirectly (through the gut) leads to a healthy heart. It has been shown to enhance gut microbiome diversity, increase beneficial bacteria, and strengthen intestinal barriers in addition to improving general cardiovascular health
Smoking is not only detrimental to the heart but also to the gut. Nicotine in cigarette smoke narrows and hardens blood vessels and raises the heart rate, therefore, causing high blood pressure. Smoking also modifies gut bacterial composition by mechanisms such as the alteration of intestinal pH. It can also alter gut permeability, leading to a leaky gut.
By following the above advice that focuses on preventative medicine, dietary improvement, and healthy lifestyle choices, we can take charge of our heart health, build a stronger gut-heart connection, and steer away from heart disease.
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Yes, the gut microbiome has been linked to atherosclerosis, heart failure, and cardiovascular events.
The gut has bacteria, which produce byproducts that have several physiological functions such as blood pressure regulation, immune system modulation, and glucose/lipid homeostasis maintenance. Changes in the gut microbiome lead to modified expression of certain metabolites, which can contribute to heart disease. In the case of a leaky intestinal lining, gut bacteria can also enter the bloodstream and induce inflammation.
Pathologies involving the gut, such as IBS, can cause heart palpitations. In IBS, nutrient absorption is disrupted, which leads to magnesium and vitamin B deficiency. This ultimately affects the heart rhythm.