The mediating role of inflammatory factors in the association between dietary index for gut microbiota and hypertension

Hypertension is a major global health concern, closely linked to cardiovascular, renal, and cerebrovascular diseases. This study investigates the relationship between the dietary index for gut microbiota (DI-GM) and hypertension, focusing on the role of inflammatory factors as mediators. We analyzed data from 21,212 participants in the NHANES 2007-2018 dataset. The results show that higher DI-GM scores are significantly associated with a reduced risk of hypertension, particularly systolic blood pressure. Mediation analysis further reveals that inflammatory factors-specifically white blood cell count, neutrophils, and systemic inflammatory index (SII)-partially mediate this relationship. The mediating effects of white blood cell count, neutrophils, and SII account for 9.07%, 8.64%, and 3.97% of the total effect, respectively. These findings suggest that dietary patterns associated with gut microbiota health are inversely related to hypertension risk, and this association may be partially explained by systemic inflammation. This study highlights the potential of diet as a non-pharmacological strategy for managing hypertension and emphasizes the importance of gut microbiota in blood pressure regulation. Our results provide new insights into the complex interactions between diet, gut health, inflammation, and blood pressure control, suggesting that dietary modifications could be a key intervention in hypertension prevention and management.