Is the Oral Microbiome Associated with Blood Pressure in Older Women?

  • Joshua H. Gordon
  • Michael J. LaMonteEmail author
  • Robert J. Genco
  • Jiwei Zhao
  • Lu Li
  • Kathleen M. Hovey
  • Maria Tsompana
  • Michael J. Buck
  • Christopher A. Andrews
  • Daniel I. Mcskimming
  • Wei Zheng
  • Yijun Sun
  • Jean Wactawski-Wende
Original article



A possible role of the oral microbiome, specifically oral nitrate reducing flora, in blood pressure (BP) homeostasis, if proven etiologic in nature, could lead to novel mechanism-based therapy to improve hypertension prevention and control.


This cross-sectional study characterized and compared the oral microbiome between four study groups based on BP status among 446 postmenopausal women aged 53–82 years.


Three study groups were not taking hypertension medication and were separated based on BP, as follows: normal BP (systolic < 120 and diastolic < 80; N = 179), elevated BP/Stage I hypertension (systolic 120–139 or diastolic 80–90; N = 106), Stage II hypertension (systolic > 140 or diastolic > 90; N = 42). The forth group consisted of anyone taking hypertension medications, regardless of BP (N = 119). Subgingival microbiome composition was determined using 16S rRNA sequencing with the Illumina MiSeq platform. Kruskal–Wallis tests were used to compare species-level relative abundance of bacterial operational taxonomic units across the four groups.


Sixty-five bacterial species demonstrated significant differences in relative abundance in women with elevated BP or using hypertension medication as compared to those with normal BP. After correction for multiple testing, two species, Prevotella oral (species 317) and Streptococcus oralis, remained significant and were lower in abundance among women taking antihypertension medications compared to those with normal BP (corrected P < 0.05).


These data provide novel description of oral subgingival bacteria grouped according to BP status. Additional larger studies including functional analysis and prospective designs will help further assess the potential role of the oral microbiome in BP regulation and hypertension.


Microbiome Blood pressure Mechanism Hypertension Women Epidemiology Microbiology 



The WHI program is funded by the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. The Buffalo OsteoPerio Study is funded by the following funding sources: NHLBI contract N01WH32122; National Institute for Dental and Craniofacial Research Grants: DE13505, DE4898, DE022654, and DE024523; U.S. Army Reserve Medical Corps Grant: DAMD17-96-1-6319.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest or relevant disclosures to report.

Ethical approval

The OsteoPerio Study and the protocols were reviewed and approved by the University at Bufalo Institutional Review Board.

Informed consent

All participants provided written informed consent.

Supplementary material

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Supplementary material 1 (PDF 48 kb)
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Supplementary material 6 (PDF 112 kb)


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Copyright information

© Italian Society of Hypertension 2019

Authors and Affiliations

  • Joshua H. Gordon
    • 1
  • Michael J. LaMonte
    • 1
    Email author
  • Robert J. Genco
    • 2
  • Jiwei Zhao
    • 3
  • Lu Li
    • 4
  • Kathleen M. Hovey
    • 1
  • Maria Tsompana
    • 5
  • Michael J. Buck
    • 5
  • Christopher A. Andrews
    • 6
  • Daniel I. Mcskimming
    • 7
  • Wei Zheng
    • 4
  • Yijun Sun
    • 4
  • Jean Wactawski-Wende
    • 1
  1. 1.Department of Epidemiology and Environmental Health, School of Public Health and Health ProfessionsUniversity at BuffaloBuffaloUSA
  2. 2.Department of Oral Biology, School of Dental Medicine, UB Microbiome CenterUniversity at BuffaloBuffaloUSA
  3. 3.Department of Biostatistics, School of Public Health and Health ProfessionsUniversity at BuffaloBuffaloUSA
  4. 4.Department of Computer and Engineering Science, NY State Center of Excellence in Bioinformatics and Life SciencesUniversity at BuffaloBuffaloUSA
  5. 5.Department of Biochemistry, NY State Center of Excellence in Bioinformatics and Life SciencesUniversity at BuffaloBuffaloUSA
  6. 6.Department of OphthalmologyUniversity of Michigan Medical SchoolAnn ArborUSA
  7. 7.Genome Environment, and Microbiome Center of ExcellenceUniversity at BuffaloBuffaloUSA

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