{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:19:08Z","timestamp":1788963548482,"version":"build-2803163510"},"reference-count":67,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>The gut microbiota is an established modulator of blood pressure, but the oral bacteriome and the fungal mycobiome have been examined largely in isolation from it and from each other. No previous synthesis has evaluated all three compartments within one analytical framework, or treated sex and ethnicity as primary analytical axes rather than adjustment covariates. Systematic review reported according to PRISMA 2020 and, for the synthesis, the SWiM guideline. PubMed\/MEDLINE, Embase, Scopus, and Web of Science were searched from inception to 30 June 2026. Observational human studies in adults reporting gut, oral, or fungal microbiota data stratified by blood pressure status were eligible, together with Mendelian randomisation studies and studies with a nested experimental causal component. Two reviewers screened and extracted independently, with a third resolving disagreement. Risk of bias was assessed with the Newcastle\u2013Ottawa Scale and certainty of evidence with GRADE adapted for exposure\u2013outcome questions. Increased abundance of the Ruminococcus gnavus group was the most convergent taxon-level finding, replicated in three independent populations on two continents, including one prospective multi-ethnic cohort with full adjustment and correction for multiple comparisons (OR 1.07, 95% CI 1.01\u20131.14 for incident hypertension). In the oral compartment, depletion of the nitrate-reducing commensal Neisseria subflava converged across a United States prospective cohort and an Italian case\u2013control study using unrelated methods, and salivary nitric oxide was approximately three-fold lower in hypertensive subjects. Depletion of the short-chain fatty acid producers Faecalibacterium and Roseburia and enrichment of Klebsiella were convergent but geographically restricted. Mycobiome evidence was contradictory: two studies reported fungal dysbiosis, one of them already at the pre-hypertensive stage, while a cross-cohort metagenome-wide study on two independent cohorts from Beijing and Dalian (N = 159 hypertensive patients, 101 healthy controls) identified 61 gut bacterial species with consistent altered abundance across both cohorts while finding no replicable mycobiome signal. Recurring across compartments and kingdoms was the collapse of microbial co-correlation networks in hypertension, alongside a dissociation between null alpha diversity and significant beta diversity. Associations differed by ethnicity within a single multi-ethnic cohort and were generally stronger in women. Certainty of evidence, assessed per individual convergent finding, was very low for every taxon-level finding and low for salivary nitric oxide; these ratings concern the attribution of hypertension to specific organisms, not the existence of a microbiota\u2013hypertension association, which is supported at community level in every compartment examined and by experimental transfer models. That the microbiota differs in hypertension is well supported; which organisms are responsible is not. The most reproducible signal is structural rather than taxonomic, and conventional differential-abundance analysis is not designed to detect it. No individual microbial taxon is currently ready to serve as a marker of hypertension or to inform clinical practice.<\/jats:p>","DOI":"10.3390\/ijms27188029","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:02:48Z","timestamp":1788962568000},"page":"8029","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut, Oral, and Fungal Microbiota in Hypertension: A Multi-Compartment Systematic Review"],"prefix":"10.3390","volume":"27","author":[{"given":"Francesco","family":"Carini","sequence":"first","affiliation":[{"name":"Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Human Anatomy and Histology, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Sorce","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal and Specialistic Medicine, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8245-9219","authenticated-orcid":false,"given":"Maria Elena","family":"Ciuppa","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal and Specialistic Medicine, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"David","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in the Medical, Surgical, and Intensive Care Fields, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-6329","authenticated-orcid":false,"given":"Marco","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in the Medical, Surgical, and Intensive Care Fields, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-5855","authenticated-orcid":false,"given":"Paola","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal and Specialistic Medicine, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Evola","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Department of Medicine and Cardiology, Azienda Ospedaliera Universitaria Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3071-822X","authenticated-orcid":false,"given":"Giovanni","family":"Tomasello","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Human Anatomy and Histology, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8500-8671","authenticated-orcid":false,"given":"Giuseppe","family":"Mul\u00e8","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal and Specialistic Medicine, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-8823","authenticated-orcid":false,"given":"Caterina","family":"Carollo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal and Specialistic Medicine, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 398, 957\u2013980."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_3","first-page":"1269","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults","volume":"71","author":"Whelton","year":"2018","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40168-016-0222-x","article-title":"Gut microbiota dysbiosis contributes to the development of hypertension","volume":"5","author":"Li","year":"2017","journal-title":"Microbiome"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Li, Y., Fu, R., Li, R., Zeng, J., Liu, T., Li, X., and Jiang, W. (2023). Causality of gut microbiome and hypertension: A bidirectional Mendelian randomization study. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1167346"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4410","DOI":"10.1073\/pnas.1215927110","article-title":"Olfactory receptor responding to gut microbiota-derived signals plays a role in renin secretion and blood pressure regulation","volume":"110","author":"Pluznick","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1161\/HYPERTENSIONAHA.115.05315","article-title":"Gut dysbiosis is linked to hypertension","volume":"65","author":"Yang","year":"2015","journal-title":"Hypertension"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1042\/CS20180087","article-title":"Imbalance of gut microbiome and intestinal epithelial barrier dysfunction in patients with high blood pressure","volume":"132","author":"Kim","year":"2018","journal-title":"Clin. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/nature09922","article-title":"Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease","volume":"472","author":"Wang","year":"2011","journal-title":"Nature"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/jcmm.13307","article-title":"Circulating trimethylamine N-oxide and the risk of cardiovascular diseases: A systematic review and meta-analysis of 11 prospective cohort studies","volume":"22","author":"Qi","year":"2018","journal-title":"J. Cell. Mol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1161\/ATVBAHA.118.311023","article-title":"Gut microbiota\u2013dependent trimethylamine N-oxide predicts risk of cardiovascular events in patients with stroke and is related to proinflammatory monocytes","volume":"38","author":"Haghikia","year":"2018","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_12","first-page":"188","article-title":"Trimethylamine N-oxide and cardiovascular outcomes in patients with chronic heart failure after myocardial infarction","volume":"7","author":"Zhou","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e36784","DOI":"10.1097\/MD.0000000000036784","article-title":"Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis","volume":"103","author":"Han","year":"2024","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hyde, E.R., Andrade, F., Vaksman, Z., Parthasarathy, K., Jiang, H., Parthasarathy, D.K., Torregrossa, A.C., Tribble, G., Kaplan, H.B., and Petrosino, J.F. (2014). Metagenomic analysis of nitrate-reducing bacteria in the oral cavity: Implications for nitric oxide homeostasis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088645"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11906-017-0725-2","article-title":"Oral microbiome and nitric oxide: The missing link in the management of blood pressure","volume":"19","author":"Bryan","year":"2017","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e021930","DOI":"10.1161\/JAHA.121.021930","article-title":"Oral microbiome is associated with incident hypertension among postmenopausal women","volume":"11","author":"LaMonte","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.niox.2020.11.002","article-title":"Association between hypertension, oral microbiome and salivary nitric oxide: A case\u2013control study","volume":"106","author":"Barbadoro","year":"2021","journal-title":"Nitric Oxide"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jare.2022.03.007","article-title":"Roles of oral microbiota and oral-gut microbial transmission in hypertension","volume":"43","author":"Chen","year":"2023","journal-title":"J. Adv. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zou, Y., Ge, A., Lydia, B., Huang, C., Wang, Q., and Yu, Y. (2022). Gut mycobiome dysbiosis contributes to the development of hypertension and its response to immunoglobulin light chains. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1089295"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e01956-22","DOI":"10.1128\/spectrum.01956-22","article-title":"Characteristics and correlations of the oral and gut fungal microbiome with hypertension","volume":"11","author":"Chen","year":"2023","journal-title":"Microbiol. Spectr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e00657-25","DOI":"10.1128\/msystems.00657-25","article-title":"Cross-cohort microbiome-wide study reveals consistent alterations in the gut bacteriome, but not the gut mycobiome, in patients with hypertension","volume":"10","author":"Gao","year":"2025","journal-title":"mSystems"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Avram, A.C., Craciun, M.L., Pah, A.M., Buleu, F., Cotet, I.G., Mateescu, D.M., Iurciuc, S., Crisan, S., Belei, O., and Militaru, A.G. (2025). Association between gut microbiome alterations and hypertension-related cardiovascular outcomes: A systematic review and meta-analysis. Microbiol. Res., 16.","DOI":"10.3390\/microbiolres16110244"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2459919","DOI":"10.1080\/20002297.2025.2459919","article-title":"The association between the oral microbiome and hypertension: A systematic review","volume":"17","year":"2025","journal-title":"J. Oral Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Guo, Y., Li, X., Wang, Z., and Yu, B. (2021). Gut microbiota dysbiosis in human hypertension: A systematic review of observational studies. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.650227"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4259","DOI":"10.1093\/eurheartj\/ehaa704","article-title":"Associations between gut microbiota, faecal short-chain fatty acids, and blood pressure across ethnic groups: The HELIUS study","volume":"41","author":"Verhaar","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1038\/s41591-018-0160-1","article-title":"Depicting the composition of gut microbiota in a population with varied ethnic origins but shared geography","volume":"24","author":"Deschasaux","year":"2018","journal-title":"Nat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1097\/HJH.0000000000002878","article-title":"Gut microbiome diversity and composition is associated with hypertension in women","volume":"39","author":"Louca","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"l6890","DOI":"10.1136\/bmj.l6890","article-title":"Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline","volume":"368","author":"Campbell","year":"2020","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e0147601","DOI":"10.1371\/journal.pone.0147601","article-title":"Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis","volume":"11","author":"Modesti","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_31","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., Welch, V., and Flemyng, E. (2024). Cochrane Handbook for Systematic Reviews of Interventions, Cochrane. Version 6.5."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Guo, Z., Yu, X., Liu, Y., Hu, Q., Zhang, Z., Zhang, C., and Li, J. (2026). A comparative analysis of oral microbial communities in hypertensive patients with and without chronic periodontitis. BMC Oral Health, 26.","DOI":"10.1186\/s12903-026-08144-6"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e016641","DOI":"10.1161\/JAHA.120.016641","article-title":"Association between the gut microbiota and blood pressure in a population cohort of 6953 individuals","volume":"9","author":"Palmu","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1097\/HJH.0000000000004254","article-title":"Prospective association between the gut microbiome and incident hypertension: A 20-year cohort study","volume":"44","author":"Yeo","year":"2026","journal-title":"J. Hypertens."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/s41522-026-00952-6","article-title":"Specific gut microbes are associated with the incidence of cardiometabolic disease in the HELIUS cohort","volume":"12","author":"Verhaar","year":"2026","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1161\/HYPERTENSIONAHA.118.12109","article-title":"Gut microbiota composition and blood pressure","volume":"73","author":"Sun","year":"2019","journal-title":"Hypertension"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"872","DOI":"10.7150\/ijms.29322","article-title":"Differential analysis of hypertension-associated intestinal microbiota","volume":"16","author":"Dan","year":"2019","journal-title":"Int. J. Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1186\/s12967-023-04176-6","article-title":"Alterations of gut microbiota are associated with blood pressure: A cross-sectional clinical trial in Northwestern China","volume":"21","author":"Lv","year":"2023","journal-title":"J. Transl. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Yan, Q., Gu, Y., Li, X., Yang, W., Jia, L., Chen, C., Han, X., Huang, Y., Zhao, L., and Li, P. (2017). Alterations of the gut microbiome in hypertension. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00381"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Cheng, Y., Huang, Y., Zhu, Z., Ding, W., Liu, X., Xu, X., Chen, Y., Wang, L., Zhao, L., and Ling, Z. (2025). Gut microbiota dysbiosis and systemic inflammation in elderly Chinese hypertensive patients: A case\u2013control study. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1662578"},{"key":"ref_41","first-page":"513","article-title":"Molecular characterization of alterations in the intestinal microbiota of patients with grade 3 hypertension","volume":"44","author":"Mushtaq","year":"2019","journal-title":"Int. J. Mol. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1002\/clc.23195","article-title":"Dysbiotic gut microbes may contribute to hypertension by limiting vitamin D production","volume":"42","author":"Zuo","year":"2019","journal-title":"Clin. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Valdez-Palomares, F., Texis, T., S\u00e1nchez-Garc\u00eda, S., Mart\u00ednez-Ezquerro, J.D., Garc\u00eda-de la Torre, P., Rodr\u00edguez-Dorantes, M., Genis-Mendoza, A., Fabela, S., Palacios-Gonz\u00e1lez, B., and Gonz\u00e1lez-Covarrubias, V. (2025). Changes in the gut microbiome of older adults according to hypertension control. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1605271"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Song, J.S., Kim, J.O.R., Yoon, S.M., Kwon, M.J., and Ki, C.S. (2023). The association between gut microbiome and hypertension varies according to enterotypes: A Korean study. Front. Microbiomes, 2.","DOI":"10.3389\/frmbi.2023.1072059"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2923941","DOI":"10.1155\/2022\/2923941","article-title":"Human gut microbes associated with systolic blood pressure","volume":"2022","author":"Joishy","year":"2022","journal-title":"Int. J. Hypertens."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1161\/HYPERTENSIONAHA.118.12588","article-title":"Gut microbiota and fecal levels of short-chain fatty acids differ upon 24-hour blood pressure levels in men","volume":"74","author":"Huart","year":"2019","journal-title":"Hypertension"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"de la Cuesta-Zuluaga, J., Mueller, N.T., Alvarez-Quintero, R., Vel\u00e1squez-Mej\u00eda, E.P., Sierra, J.A., Corrales-Agudelo, V., Carmona, J.A., Abad, J.M., and Escobar, J.S. (2018). Higher fecal short-chain fatty acid levels are associated with gut microbiome dysbiosis, obesity, hypertension and cardiometabolic disease risk factors. Nutrients, 11.","DOI":"10.3390\/nu11010051"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Liu, S., Luo, X., Zhou, J., Wang, L., Li, R., Luo, Z., Li, N., Xiao, S., and Zhang, P. (2026). A comparative study of the gut microbiome and fecal metabolome in hypertensive patients from middle-temperate and tropical cities of China: Daqing and Haikou. Front. Microbiol., 17.","DOI":"10.3389\/fmicb.2026.1801806"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e268","DOI":"10.1002\/imt2.268","article-title":"Non-differential gut microbes contribute to hypertension and its severity through co-abundances: A multi-regional prospective cohort study","volume":"4","author":"Liu","year":"2025","journal-title":"iMeta"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Qu, L., Dong, Z., Ma, S., Liu, Y., Zhou, W., Wang, Z., Wu, C., Ma, R., Jiang, X., and Zu, T. (2022). Gut microbiome signatures are predictive of cognitive impairment in hypertension patients\u2014A cohort study. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.841614"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Silveira-Nunes, G., Durso, D.F., de Oliveira, L.R.A., Cunha, E.H.M., Maioli, T.U., Vieira, A.T., Speziali, E., Corr\u00eaa-Oliveira, R., Martins-Filho, O.A., and Teixeira-Carvalho, A. (2020). Hypertension is associated with intestinal microbiota dysbiosis and inflammation in a Brazilian population. Front. Pharmacol., 11.","DOI":"10.3389\/fphar.2020.00258"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e00092-18","DOI":"10.1128\/mSphere.00092-18","article-title":"Investigating colonization of the healthy adult gastrointestinal tract by fungi","volume":"3","author":"Auchtung","year":"2018","journal-title":"mSphere"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s40168-017-0373-4","article-title":"The gut mycobiome of the Human Microbiome Project healthy cohort","volume":"5","author":"Nash","year":"2017","journal-title":"Microbiome"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1126\/science.1221789","article-title":"Interactions between commensal fungi and the C-type lectin receptor Dectin-1 influence colitis","volume":"336","author":"Iliev","year":"2012","journal-title":"Science"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"12672","DOI":"10.1073\/pnas.1904099116","article-title":"Ruminococcus gnavus, a member of the human gut microbiome associated with Crohn\u2019s disease, produces an inflammatory polysaccharide","volume":"116","author":"Henke","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1194\/jlr.R500013-JLR200","article-title":"Bile salt biotransformations by human intestinal bacteria","volume":"47","author":"Ridlon","year":"2006","journal-title":"J. Lipid Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3459","DOI":"10.1093\/eurheartj\/ehz646","article-title":"Causal association between periodontitis and hypertension: Evidence from Mendelian randomization and a randomized controlled trial of non-surgical periodontal therapy","volume":"40","author":"Osmenda","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/s41467-022-28034-z","article-title":"Microbiome differential abundance methods produce different results across 38 datasets","volume":"13","author":"Nearing","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1210\/er.2001-0045","article-title":"Estrogen modulation of endothelial nitric oxide synthase","volume":"23","author":"Chambliss","year":"2002","journal-title":"Endocr. Rev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1038\/s43856-025-00980-x","article-title":"The association between the gut microbiome and 24-h blood pressure measurements in the SCAPIS study","volume":"5","author":"Lin","year":"2025","journal-title":"Commun. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_62","unstructured":"Rothman, K.J., Greenland, S., and Lash, T.L. (2008). Modern Epidemiology, Lippincott Williams & Wilkins. [3rd ed.]."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1161\/HYPERTENSIONAHA.109.133900","article-title":"Predictive role of the nighttime blood pressure","volume":"57","author":"Hansen","year":"2011","journal-title":"Hypertension"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1128\/jb.105.3.999-1005.1971","article-title":"Lactate metabolism by Veillonella parvula","volume":"105","author":"Ng","year":"1971","journal-title":"J. Bacteriol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/nature25979","article-title":"Extensive impact of non-antibiotic drugs on human gut bacteria","volume":"555","author":"Maier","year":"2018","journal-title":"Nature"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1038\/s41467-018-05184-7","article-title":"Gut microbiota associations with common diseases and prescription medications in a population-based cohort","volume":"9","author":"Jackson","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Tsiavos, A., Antza, C., Trakatelli, C., and Kotsis, V. (2024). The microbial perspective: A systematic literature review on hypertension and gut microbiota. 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