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How Gut Health Affects Your Blood Pressure

Medically reviewed by Kevin Tin, MD, Asma Khapra, MD, Susan Kerrigan, MD and Marianne Madsen on March 28, 2023

“Eat right and exercise” has become a medical catch-all to the point of weariness. Is there anything that can’t be cured by broccoli and jumping jacks? Yet many doctors, when diagnosing patients with hypertension, will offer this exact advice. For the patient, it can be challenging to make radical changes to her diet. She may question whether it is worthwhile to eat more vegetables. “Will this really help lower my blood pressure?” However, new research in the field of hypertension can help new patients understand the importance of including more plant-based foods into their diet. A 2021 study helps explain how flavonoids enrich the gut’s microbiome to lower blood pressure.


What is hypertension?


Hypertension occurs when a person’s blood pressure consistently reaches above healthy norms. Blood pressure is determined by measuring the systolic and diastolic pressure in the arteries. The systolic pressure records the blood pressure when the heart beats, and the diastolic blood pressure records the blood pressure when the heart is at rest.  When systolic blood pressure reaches over 130 or the diastolic pressure is over 80, the patient may be at risk of hypertension. It’s important to keep an eye on blood pressure levels as very high levels can lead to serious conditions such as heart attacks, stroke, or heart disease.


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Hypertension - Overview

Hypertension - Overview

What are flavonoids?


Flavonoids are plant-based substances that can provide many health benefits such as anti-oxidation (protects cells from unstable molecules), anti-inflammation (reduces inflammation), anti-mutagenicity (prevents cell mutations), and anti-carcinogenicity (prevents or delays cancer). They can be found in tea, berries, wine, and chocolate, and other fruits and vegetables. There are 6 types of flavonoids: flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, and flavonoid polymers. Each category has a different chemical structure and offers different medical advantages.


What is the microbiome?


Inside the human body is a world of bacteria, fungi, and viruses. Each of these organisms interact with the host body to provide different functions. While some people think of bacteria as harmful, the microbiome offers many advantages such as protection against harmful organisms, production of nutrients and vitamins, and storage of fat. It can even affect the behavior of the host. The microbiome is an ever-changing ecosystem that can be influenced by diet, antibiotics, and other ingestible substances.


The relationship between flavonoids and gut health


While they do provide a plethora of nutritional and medical benefits, many flavonoids cannot immediately be absorbed into the body. They need to first be processed by the gut’s microbiome. As the gut’s bacteria and flavonoids interact, both are broken down and changed into new substances. These substances offer increased bioactivity that allows them to help the body in unique ways that were not available in their original forms. The new properties are only available after the flavonoids have been broken down.


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Hypertension - Prevention

Hypertension - Prevention

Effects of flavonoid intake and gut microbiome on hypertension


For years scientists have known about the positive influence of flavonoids on gut health and the body. Recently, a team of researchers in Germany looked to further understand this relationship by observing how flavonoids can influence blood pressure. 


Over 900 study participants recorded and submitted their dietary intake for a year using a 112-item food frequency questionnaire. Then the researchers measured the participants’ blood pressure and extracted their fecal bacterial DNA.They assigned a flavonoid content value to each food item listed in the questionnaire using data from the U.S. Department of Agriculture. All the 6 main subclasses of flavonoids were included in the study.


From the results of the study, researchers observed a 15.2% reduction of participants’ systolic blood pressure that could be attributed to flavonoid-rich foods interacting with the gut microbiome. While 15% may not seem like a large number, it actually represents a tremendous improvement in the participants’ blood pressure. The researchers also found that berries and red wine were the most effective in reducing systolic blood pressure, but apples and pears were helpful as well. This study is an important step forward to help patients and medical professionals understand how the flavonoid interaction with the microbiome can reduce hypertension. It also gives a deeper insight into which foods should be eaten to lower blood pressure in hypertension patients.


Healthy diet and lower blood pressure


Maintaining a healthy diet is essential to lowering blood pressure in patients with hypertension. However, knowing which foods to include in your diet can be tricky. Is it enough to eat any “healthy food?” Or are there some foods which are more effective at lowering blood pressure than others? 


This study shows that foods which are rich in flavonoids, such as berries, apples, pears, and red wine, can help lower blood pressure. The flavonoids’ interaction with the gut’s microbiome releases cardioprotective (protects the cardiovascular system) properties that can bring down hypertension. But knowing which food to include in your diet is more than just a “gut feeling.” A conversation with your doctor or nutritionist can help clarify which flavonoid-rich foods you should be chowing down on.

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