Gut Microbiota Modulation in Atherosclerotic Cardiovascular Disease

Atherosclerotic cardiovascular disease arises from lipid deposition, inflammation and plaque formation in arterial walls. The gut microbiota influences these processes through diverse mechanisms. Dysbiosis can alter bile acid metabolism, cholesterol homeostasis and immune function, while microbial metabolites such as trimethylamine N-oxide and short-chain fatty acids exert systemic effects on vascular integrity and inflammation. Experimental models and human studies have demonstrated that targeted interventions—such as dietary fibre supplementation, probiotics, prebiotics or faecal microbiota transplantation—can reshape microbial communities, modulate inflammatory pathways and attenuate plaque progression. Advances in multi-omic profiling have elucidated microbial signatures predictive of disease onset and progression, underscoring the gut–heart axis as a novel therapeutic frontier. This research holds global significance, offering potential for personalised nutrition, biomarker development and microbiota-based therapies to reduce cardiovascular risk.

Research from Nature Portfolio

Recent studies have employed large-scale metagenome and metabolome analyses to characterise gut microbial changes across the spectrum of cardiometabolic health and disease. A comprehensive metagenome-wide association investigation revealed that individuals with atherosclerotic cardiovascular disease exhibit increased abundance of pro-inflammatory taxa such as Enterobacteriaceae and Streptococcus spp and show altered potential for lipid and amino acid metabolism. Comparative analyses with other disorders identified common microbial features, providing a resource for mechanistic investigation. Another study integrating serum and urine metabolomics with gut metagenomics identified novel microbial metabolites—including specific phosphosugars and sugar alcohols—associated with coronary heart disease, linking metabolites of microbial origin to clinical biochemical indices and suggesting new biomarker candidates. A longitudinal cohort encompassing healthy, dysmetabolic and ischaemic heart disease stages demonstrated that most microbial and metabolic alterations precede clinical onset, highlighting specific microbiome and metabolome signatures that distinguish subtypes of ischaemic heart disease more accurately than traditional risk factors.

Gut Microbiota Modulation in Atherosclerotic Cardiovascular Disease publication trend

The graph below shows the total number of articles in gut microbiota modulation in atherosclerotic cardiovascular disease across all publications each year (not limited to Nature Index journals).

Technical terms

Gut microbiota: The complex community of bacteria, archaea, viruses and fungi residing in the gastrointestinal tract.

Atherosclerotic cardiovascular disease: A condition characterised by the build-up of lipid-rich plaques within arterial walls, leading to impaired blood flow and increased risk of cardiac events.

Dysbiosis: An imbalance in the composition or function of the gut microbiota that can contribute to disease.

Short-chain fatty acids (SCFAs): Metabolites produced by microbial fermentation of dietary fibres, which modulate host energy metabolism and inflammation.

Trimethylamine N-oxide (TMAO): A pro-atherogenic metabolite generated from dietary choline by gut microbes and hepatic oxidation.

Metagenomics: The study of genetic material recovered directly from environmental samples, enabling characterisation of microbial communities.

Metabolomics: The comprehensive analysis of small molecules and metabolites within biological systems, reflecting functional metabolic states.

Fermentable dietary fibre: Indigestible carbohydrates that are fermented by gut microbes, often leading to beneficial metabolite production.

References

1. Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort. Circulation (2023).
2. Pleiotropic activities of succinate: The interplay between gut microbiota and cardiovascular diseases. iMeta (2023).
3. Dissecting the impact of dietary fiber type on atherosclerosis in mice colonized with different gut microbial communities. npj Biofilms and Microbiomes (2023).
4. Microbiome and metabolome features of the cardiometabolic disease spectrum. Nature Medicine (2022).
5. Integrated metabolomics and metagenomics analysis of plasma and urine identified microbial metabolites associated with coronary heart disease. Scientific Reports (2016).
6. The gut microbiome in atherosclerotic cardiovascular disease. Nature Communications (2017).