title: Oral Microbiome and Nitric Oxide: the Missing Link in the Management of Blood Pressure.
abstract: Having high blood pressure puts you at risk for heart disease and stroke, which are leading causes of death in the USA and worldwide. One out of every three Americans has hypertension, and it is estimated that despite aggressive treatment with medications, only about half of those medicated have managed blood pressure. Recent discoveries of the oral microbiome that reduces inorganic nitrate to nitrite and nitric oxide provide a new therapeutic target for the management of hypertension. The presence or absence of select and specific bacteria may determine steady-state blood pressure levels. Eradication of oral bacteria through antiseptic mouthwash or overuse of antibiotics causes blood pressure to increase. Allowing recolonization of nitrate- and nitrite-reducing bacteria can normalize blood pressure. This review will provide evidence of the link between oral microbiota and the production of nitric oxide and regulation of systemic blood pressure. Management of systemic hypertension through maintenance of the oral microbiome is a completely new paradigm in cardiovascular medicine.
authors.affiliation: Department of Molecular and Human Genetics, Baylor College of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA. Nathan.bryan@bcm.edu.
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Bryan
authors.affiliation: Department of Periodontics, The University of Texas Health Science Center at Houston, 7000 Fannin, Houston, TX, 77030, USA.
authors.forename: Gena
authors.initials: G
authors.lastname: Tribble
authors.affiliation: Department of Periodontics, The University of Texas Health Science Center at Houston, 7000 Fannin, Houston, TX, 77030, USA.
authors.forename: Nikola
authors.initials: N
authors.lastname: Angelov
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000382:microbiology*; D064307:Microbiota; D009566:Nitrates / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism*; D009573:Nitrites / Q000378:metabolism
chemical_list: D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide
keywords: Blood pressure; Diet; Gut microbiome; Hypertension; Nitrate; Nitric oxide; Nitrite