ASSOCIATION OF THE NEWLY PROPOSED DIETARY INDEX FOR GUT MICROBIOTA AND HYPERTENSION: THE MEDIATION EFFECT OF BODY MASS INDEX

Objective: Novel strategies for the treatment and prevention of hypertension are actively under investigation. Recent research has revealed a connection between gut microbiota and hypertension, as well as the effects of dietary interventions on blood pressure regulation. The Dietary Index for Gut Microbiota (DI-GM), a newly proposed index that reflects gut microbiota diversity has not yet been studied in relation to hypertension. Design and method: Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed to examine the relationship between the DI-GM and hypertension. DI-GM scores, calculated from dietary recall data, included components both beneficial and detrimental to gut microbiota. Univariable and multivariable weighted logistic regression were used to evaluate this association, while the potential mediating effect of body mass index (BMI) was also explored. Secondary analyses included subgroup analyses and multiple imputation to address missing data. Results: 19490 participants were included in the study. When treated as a continuous variable, a higher DI-GM and beneficial gut microbiota score were associated with a lower prevalence of hypertension after full adjustments (OR = 0.93, 95% CI=0.91-0.96, p < 0.001). Categorically, the highest DI-GM group (DI-GM >= 6) exhibited a significant inverse association with hypertension (OR = 0.77, 95% CI=0.66-0.90, p=0.001). Subgroup analyses demonstrated that the correlation remained consistent across different age and gender groups. Notably, the association was significant exclusively within the high physical activity subgroup. Besides, BMI showed a significant mediating effect, accounting for 32.25% of the association (95% CI: 21.43%-51.00%, p < 0.001). Conclusions: The newly proposed DI-GM was negatively associated with the prevalence of hypertension. Mediation analyses demonstrated a significant mediating effect of BMI. Therefore, incorporating microbiota profile into risk assessments could improve the prediction of hypertension susceptibility. Furthermore, integrating gut microbiota modulation into standard hypertension management protocols presents a promising strategy to enhance therapeutic outcomes.