Author + information
- Received May 8, 2018
- Revision received March 9, 2019
- Accepted March 12, 2019
- Published online April 22, 2019.
- W.H. Wilson Tang, MDa,b,c,∗ (, )@WilsonTangMD,
- Fredrik Bäckhed, PhDd,e,
- Ulf Landmesser, MDf and
- Stanley L. Hazen, MDa,b
- aCenter for Microbiome and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- bDepartment of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- cCenter for Clinical Genomics, Cleveland Clinic, Cleveland, Ohio
- dUniversity of Gothenburg, Gothenburg, Sweden
- eNovo Nordisk Foundation Center for Basic Metabolic Research and Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- fCharité Universitätsmedizin Berlin, Berlin Institute of Health (BIH), Berlin, Germany and German Center for Cardiovascular Research (DZHK), Berlin, Germany
- ↵∗Address for correspondence:
Dr. W.H. Wilson Tang, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, Ohio 44195.
• Intestinal microbiota are mechanistically linked to physiological processes that affect cardiovascular health.
• Dietary nutrients serve as key environmental influences to intestinal microbiota and human host metabolism.
• Modulating intestinal microbiota composition and metabolism may serve as targets for cardiovascular disease prevention.
Despite major strides in reducing cardiovascular disease (CVD) burden with modification of classic CVD risk factors, significant residual risks remain. Recent discoveries that linked intestinal microbiota and CVD have broadened our understanding of how dietary nutrients may affect cardiovascular health and disease. Although next-generation sequencing techniques can identify gut microbial community participants and provide insights into microbial composition shifts in response to physiological responses and dietary exposures, provisions of prebiotics or probiotics have yet to show therapeutic benefit for CVD. Our evolving understanding of intestinal microbiota-derived physiological modulators (e.g., short-chain fatty acids) and pathogenic mediators (e.g., trimethylamine N-oxide) of host disease susceptibility have created novel potential therapeutic opportunities for improved cardiovascular health. This review discusses the roles of human intestinal microbiota in normal physiology, their associations with CVD susceptibilities, and the potential of modulating intestinal microbiota composition and metabolism as a novel therapeutic target for CVD.
This work is supported by grants from the National Institutes of Health (NIH), the Ofﬁce of Dietary Supplements (R01HL103866, P20HL113452, R01DK106000, R01HL126827), and the Fondation Leducq (17CVD01). Dr. Tang has served as a consultant for The Advisory Board Company. Dr. Bäckhed is the founder and a shareholder of Metabogen AB. Dr. Hazen is a co-inventor on pending and issued patents held by the Cleveland Clinic related to cardiovascular diagnostics and therapeutics; has been a paid consultant for Proctor and Gamble (P&G); has received research funds from P&G and Roche Diagnostics; and is eligible to receive royalty payments for inventions or discoveries related to cardiovascular diagnostics or therapeutics from Cleveland HeartLab and P&G. Dr. Landmesser has reported that he has no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received May 8, 2018.
- Revision received March 9, 2019.
- Accepted March 12, 2019.
- 2019 American College of Cardiology Foundation
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