Oral Microbiome and Nitric Oxide: the Missing Link in the Management of Blood Pressure

Area of Science:

• Cardiovascular Medicine
• Microbiology
• Hypertension Research

Background:

• Hypertension affects one in three Americans, with many experiencing uncontrolled blood pressure despite medication.
• Cardiovascular diseases, including heart disease and stroke, are leading global causes of death.
• The oral microbiome's role in cardiovascular health is an emerging area of research.

Purpose of the Study:

• To review the evidence linking the oral microbiota to nitric oxide production and systemic blood pressure regulation.
• To explore the oral microbiome as a novel therapeutic target for hypertension management.
• To introduce a new paradigm for managing systemic hypertension through oral microbiome maintenance.

Main Methods:

• Literature review of studies investigating the oral microbiome, nitrate-nitrite-nitric oxide metabolism, and blood pressure.
• Analysis of research on the impact of oral bacteria eradication and recolonization on blood pressure.
• Synthesis of findings on the relationship between specific oral bacteria and hypertension.

Main Results:

• Specific oral bacteria reduce inorganic nitrate to nitrite and nitric oxide, influencing blood pressure.
• Eradication of oral bacteria (e.g., via antiseptic mouthwash or antibiotics) can lead to increased blood pressure.
• Recolonization with nitrate- and nitrite-reducing oral bacteria can help normalize blood pressure.

Conclusions:

• The oral microbiome is a critical regulator of systemic blood pressure.
• Maintaining a healthy oral microbiome offers a novel therapeutic strategy for managing hypertension.
• Targeting the oral microbiota represents a new paradigm in cardiovascular medicine for hypertension control.