Marc D Cook, Pritha Das, Jarrad Hampton-Marcell, Ian Carroll, Taylor Hogue, Sebastian Reczek, Yvonne Ford, Devanshi Raval
Journal: Journal of the American Heart Association 2025;14(17):e039759
PMID: 40736085
High blood pressure increases the risk of heart disease, stroke, and kidney disease. Black adults are disproportionately affected by high blood pressure and often develop it earlier and with greater severity. Emerging research suggests that the gut microbiome, the bacteria living in the digestive tract, may influence blood pressure. One substance produced by gut bacteria is butyrate, a short-chain fatty acid that may affect blood vessel function and inflammation. This proof-of-concept randomised controlled trial aimed to examine whether delivering butyrate directly to the gut could lower blood pressure over a short period of time.
The results showed that participants with high blood pressure experienced a significant reduction in systolic blood pressure within 24 hours of butyrate delivery. The effect was not observed to the same extent in participants with normal blood pressure. These findings suggest that increasing gut-derived butyrate may help regulate blood pressure in individuals with high blood pressure.
In conclusion, butyrate may play a role in short-term blood pressure regulation in black individuals with hypertension. However, because the study was small and short-term, larger and longer trials are needed before clinical recommendations can be made. Healthcare professionals may use these findings to consider the potential importance of gut health and dietary fibre intake, which promotes natural butyrate production, as part of a broader hypertension management strategy.
BACKGROUND
Hypertension is a global health crisis linked to increased heart disease and stroke. Black individuals have the greatest burden of hypertension and related diseases. Recent research suggests that the gut microbial production of short-chain fatty acids, such as butyrate, is associated with blood pressure (BP) regulation. We hypothesize that acutely increasing gut butyrate would lead to a significant reduction in BP within a 24-hour period.
METHODS
Ten Black adults with normal BP and 10 with stage 1 hypertension (age and sex-matched) participated in this study. In a crossover experiment, participants with hypertension randomly self-administered a low dose (5 mmol/L) and a high dose (80 mmol/L) butyrate enema 7 days apart. Blood butyrate levels were measured before and 30 minutes post enema, with BP monitored via 24-hour ambulatory devices. Preintervention fecal samples were sequenced via the V4 region of the 16S rRNA gene and microbiome characteristics assessed.
RESULTS
We observed that daytime systolic BP was significantly lower after the 80 mmol/L butyrate enema. There was no significant difference in blood butyrate between controls and the group with hypertension before or after either enema. Microbial diversity did not significantly differ between groups; however, pathways for carbohydrate fermentation were significantly lower with differentially abundance butyrate-producing microbes in participants with hypertension compared with those with normal BP.
CONCLUSIONS
This study suggests that increasing gut butyrate availability can improve BP. The findings bolster the evidence that gut butyrate regulates BP and supports studies needed to test strategies to boost gut butyrate availability for BP control.
REGISTRATION
URL: https://www.clinicaltrials.gov; Unique identifier NCT04415333.
Full Text Sources:
Medical:
© Copyright 2026, Nutrition Evidence
NED wishes to thank the following organisations for their support:
We use cookies to improve your experience and analyze site traffic with Google Analytics. By continuing to use our site, you agree to our use of cookies. Learn more.