Gut bacteria may contribute to drug resistance

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New rodent research suggests gut bacteria may interfere with the effectiveness of blood pressure medications. Paul Linse/Getty Images
  • Nearly half of all adults in the United States suffer from high blood pressure.
  • For about 20% of them, the condition does not respond to medication.
  • In a new study done on rats, researchers have found that enzymes produced by certain gut bacteria contribute to drug resistance, preventing blood pressure medications from working.
  • Doctors may be able to predict which blood pressure medications are most likely to work by profiling people’s gut microbes.
  • By changing their diet or taking medication, people may be able to change their gut microbes and increase the effectiveness of certain blood pressure medications.

According to the Centers for Disease Control and Prevention (CDC), 47% of adults in the United States suffer from hypertension or high blood pressure. The International Society of Hypertension defines hypertension as blood pressure consistently above 140 over 90 millimeters of mercury (mm Hg).

People with hypertension are at a higher risk of health complications, including heart disease, heart attacks, and strokes.

For many people, high blood pressure can be controlled with medication, diet, and exercise. However, the CDC says that only 24% of people with hypertension have their condition under control.

Now, a study from the University of Toledo, Ohio, to appear in Experimental biologyfound that gut bacteria may explain why treatment is ineffective for some people.

Resistant hypertension it is a blood pressure which remains above 140/90 mm Hg despite treatment with three antihypertensives of different classes at the best tolerated doses, including a diuretic.

Currently, doctors treat resistant hypertension by switching medications or adding additional medications to those that aren’t working. However, some people discontinue their medications due to increased side effects from several treatments. Others remain hypertensive despite extensive medical care.

In this study, researchers looked at the gut microbiome of rats. They discovered that a common intestinal bacterium, coprococcus comesmay interfere with the action of some angiotensin converting enzyme (ACE) inhibitors.

ACE inhibitorswhich include Lotensin (benazepril), Monopril (fosinopril) and Accupril (quinapril), are among the most commonly used treatments for hypertension.

In the study, researchers administered a single dose of quinapril to rats with high blood pressure. They found that the drug was less effective in reducing blood pressure in rats with a higher gut microbiota load.

To test their observations, they then gave the rats a combination of c comes and quinapril. Rats given the combination showed a smaller reduction in blood pressure than those given quinapril alone.

They then performed in vitro tests and found that c comes is broken down quinapril. They suggest it does this by producing enzymes that hydrolyze the drug, making it less effective.

Professor Tim SpectorProfessor of Epidemiology at King’s College London and Head of Zoe Covid Symptom StudyRecount Medical News Today that the findings added to the evidence on the effects of gut microbes:

“This contributes to the growing evidence that our gut microbes are crucial to the effectiveness of most common medications, and supports similar studies with antidepressant medications.”

And it’s not just medications that can be affected by gut microbes. In one recent studyProfessor Spector and his colleagues found that gut microbes can influence blood pressure in typical populations.

“We are still in the early stages of determining interactions between gut bacteria and antihypertensive drugs,” said Dr. Tao Yang, Ph.D., assistant professor at the University of Toledo and presenting author of the study. “However, our current findings suggest that the same drug may not be suitable for everyone because each person has a unique gut microbial makeup with a unique profile of enzyme activities.”

The authors are undertaking further experiments with different antihypertensives and other types of gut bacteria to further explore the interactions between the gut microbiota and antihypertensive drugs.

Dr. Yang continued, “A better understanding of the relationship between gut microbes and drug efficacy could lead to new treatment approaches for people who do not respond to blood pressure medications. This could include new drugs or modulating the gut microbiota with probiotics, antibiotics and other methods.

“As we all have unique microbial gut communities, understanding how we can optimize them through personalized approaches to our diets is crucial for future health strategies.”

– Teacher. Spector

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