Human microbiome as therapeutic intervention target to reduce cardiovascular disease risk.
The absolute burden of cardiovascular risk remains high despite currently available preventive and therapeutic options. In search for novel therapeutic leads, mounting evidence has linked the gut microbiota as well as their metabolites to the development of cardiometabolic diseases.



The intestinal microbiota influences the host via different metabolic pathways as inducer of endotoxemia, formation of trimethylamine-N-oxide, production of short chain fatty acids, and is a regulator in intestinal bile acid metabolism. Disruption of the gut microbiome may disturb the homeostasis of the microbial ecosystem to an alternative stable state associated with pathophysiological traits in microbiota and host. However, causality has not been shown yet.



We are just beginning to understand how the gut microbiota influence our cardiometabolic health and various innovative therapeutic options are in the developing (preclinical) phase. This review focuses on the current evidence whether and to what extent the intestinal microbiota are involved in cardiovascular disease and whether this is based on merely association or causal relations.
aDepartment of Vascular Medicine, Academic Medical Center, Amsterdam bLaboratory of Metabolic Diseases, Department of Pediatrics, UMCG, Groningen, The Netherlands cWallenberg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden dDepartment of Internal Medicine eICAR, VU University Medical Center, Amsterdam, The Netherlands.
Annefleur M
AM
Koopen
Albert K
AK
Groen
Max
M
Nieuwdorp
D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology*; D000069196:Gastrointestinal Microbiome / Q000187:drug effects; D006801:Humans; D064307:Microbiota / Q000187:drug effects*; D058990:Molecular Targeted Therapy / Q000379:methods*; D009206:Myocardium / Q000378:metabolism; D012306:Risk