Effects of probiotic therapy on cardio-metabolic parameters and autonomic modulation in hypertensive women: a randomized, triple-blind, placebo-controlled trial.

BACKGROUND AND AIMS: We assessed the effects of probiotic therapy for 8 weeks on cardiometabolic variables and autonomic function in women medically diagnosed with arterial hypertension. METHODS AND RESULTS: Forty women with arterial hypertension, 20-50 years, were assigned to two groups in this randomized, triple-blind, placebo-controlled clinical trial. Patients in the probiotic group received a daily sachet containing Lactobacillus para casei LPC-37, Lactobacillus rhamnosus HN001, Lactobacillus acidophilus NCFM, and Bifidobacterium lactis HN019 (109 CFU of each strain) for 8 weeks. Patients in the placebo group received identical sachets with polydextrose (1 g day-1, for 8 weeks). Anthropometric, BP, electrocardiogram, biochemical measurements, fecal microbiota composition, and glucose hydrogen breath test were assessed at baseline and after 8 weeks intervention. Anthropometric variables (weight, BMI, and waist circumference) were similar between the two groups (p > 0.05). Probiotic supplementation significantly reduced fasting glucose (change -10.3 mg dL-1, p < 0.05) and cholesterol levels (change -23.6 mg dL-1, p < 0.05), and increased the HDL-cholesterol (change 6.5 mg dL-1, p < 0.05) compared with the baseline condition. Probiotic supplementation lowered, although without statistical significance, systolic BP by about 5 mmHg and diastolic BP by about 2 mmHg in hypertensive women. Lastly, probiotic administration reduced the low frequency (LF) oscillation and LF/high frequency (HF) ratio (p < 0.05) in the frequency domain of heart rate variability, suggesting an improvement in autonomic modulation. CONCLUSION: Probiotic therapy for 8 weeks reduced fasting glucose levels, and improved the lipid profile and autonomic modulation in hypertensive women.

Gut microbiota and probiotics intervention: A potential therapeutic target for management of cardiometabolic disorders and chronic kidney disease?

The gut microbiota plays an important role in host metabolism and its dysregulation have been related to cardiometabolic disorders (CMD), such as type 2 diabetes mellitus (T2D), dyslipidemia and arterial hypertension, as well as to chronic kidney diseases (CKD). The implication of the gut microbiota on systemic disorders has been associated with changes in its composition (dysbiosis) as a result of the oxidative unbalance in the body. This alteration may be the result of the adoption of unhealthy lifestyle behavior, including lack of physical activity and fat- or sugar-rich diets, which are largely associated with increased incidence of CMD and CKD. In last years, a number of clinical trials and experimental studies have demonstrated that probiotics can modulate the host metabolism, resulting in amelioration of systemic disease phenotypes by the improvement of dyslipidemia, glycemic profile and blood pressure or CKD parameters. The beneficial effects of probiotics consumption have been associated with their anti-inflammatory, antioxidant and gut-modulating properties. Despite of some mechanistic evidence, these effects are not totally elucidated. The present review summarizes and clarifies the effects of probiotics administration on CMD and CKD using combined evidence from clinical and experimental studies. Considering that the microbiota dysregulation has been associated with inflammation and oxidative stress and consequently with CMD and CKD, supplementation with probiotics is discussed as a strategy for management of CMD and CKD.