A Randomized Controlled Trial On The Effect Of Taking Medicine And Food Homologous As Tea On Blood Pressure And Gut Microbiota In Patients With Hypertension In Community

ObjectivesHypertension is a common chronic disease that causes a great burden on human life and health.Gut microbiota affects host health in many ways and the imbalance of gut microbiota participated in the mechanism of hypertension occurrence.Apart from the effects in lowering blood pressure,blood sugar,and blood lipids,some substances in the medicine and food homologous play roles in regulating gut microbiota.At present,the influence of food therapy with medicine and food homologous on blood pressure and gut microbiota in patients with hypertension is not clear.The purpose of this study was,through conducting a 12-week intervention with taking medicine and food homologous as tea in patients with hypertension in community and comparing the results with control group included at the same period,to explore the effect of taking medicine and food homologous as tea on improving blood pressure and gut microbiota in patients with hypertension in community,and analyze the potential connection between these two aspects.The results are expected to provide scientific reference for non-pharmacological dietary treatment of patients with hypertension and offer novel ideas for healthy life style guidance to community residents in community nursing work.MethodsThis study was a randomized controlled interventional study.A total of 140 patients with hypertension in community were recruited from September 2018 to July 2019.Under the precondition of obtaining informed consent,the patients were randomly divided into the intervention group(n=70)and the control group(n=70).The control group maintained current treatment and usual lifestyle,and the intervention group accepted additional intervention with taking medicine and food homologous as tea for 12 weeks.The intervention program with medicine and food homologous was determined through literature review,expert group discussion,and preliminary experiment.Parametersincluded blood pressure,gut microbiota,glucose metabolism,lipid metabolism,liver function,kidney function,and quality of life were measured before intervention and at 12 weeks after intervention.An additional measurement was set for blood pressure at 6 weeks after intervention.During the intervention,regular follow-ups were conducted to learn any changes in medication and lifestyles,self-perceived symptoms and adverse reactions during the intervention.Patients were instructed to fill in a diary,so as the researcher to learn the intervention measure compliance.Data of results were analyzed through t-test,chi-square test,rank-sum test,repeated measures analysis of variance,correlation analysis,etc.Results1.A total of 122 patients completed the entire study,including 62 in the intervention group and 60 in the control group.Before the intervention,there were no significant differences in the general data such as age,sex,educational level,duration of hypertension,and family history of hypertension between the intervention group and the control group(P>0.05).2.The changes of various indicators in two groups of patients after intervention:(1)Blood pressure: At 12 weeks of intervention,patients in the intervention group had significantly lower systolic and diastolic blood pressure(P<0.01,P<0.05),and systolic blood pressure of patients in the intervention group was lower than those in the control group(P<0.01).In addition,the systolic blood pressure of patients in the intervention group had significantly decreased at 6 weeks of intervention(P<0.01).(2)Gut microbiota:Ace and Chao1 indexes of the two groups after intervention were higher than before intervention(P<0.01);Shannon index of the intervention group was higher than before the intervention(P<0.01),and Simpson index of the intervention group was lower than that before the intervention(P<0.05).At 12 weeks of intervention,the abundance of Clostridium and Anaerostipes in the intervention group increased(P<0.05),while Megamonas and Lachnospira decreased(P<0.05).LEf Se analysis showed that Lactobacillaceae,Leuconostoc,Lactobacillus and Anaerostipes were significantly increased in the intervention group after intervention.(3)Physical form indexes and heart rate: At 12 weeks of intervention,there were no significant differences in weight,BMI,and heart rate between the two groups of patients(P>0.05).(4)Biochemical parameters: At 12 weeks of intervention,the alanine aminotransferase and total bilirubin in the interventiongroup were lower than those in the control group(P<0.05).There were no significant differences in fasting plasma glucose,hemoglobin A1 c,and lipid metabolism indexes between the two groups of patients(P>0.05).Intra-group comparison showed that the alanine aminotransferase and total bilirubin in the intervention group were lower after intervention than before intervention(P<0.05).(5)Quality of life: At 12 weeks of intervention,the scores of the energy,mental health and the total score of SF-36 were higher in the intervention group than in the control group(P<0.05).Intra-group comparison showed that the score of the energy in intervention group was higher after intervention than before intervention(P<0.05).3.Correlation between blood pressure and the abundance of bacteria: Analysis of the data after intervention among two groups of patients found that the abundance of Eubacterium and Alistipes were in positive correlation with systolic blood pressure(P<0.05),and the abundance of Roseburia was in positive correlation with diastolic blood pressure(P<0.05).4.There were 87.1 % of the patients in the intervention group who took medicine and food homologous as tea ? 6 days per week,and there were 59.68% patients had a daily dose of 1000 to 1500 m L.During the intervention period,all patients had no adverse reactions including abdominal pain,syncope,hypotension,loss of appetite,muscle soreness,rash,etc.ConclusionsThe 12-week of intervention program with taking medicine and food homologous as tea used in this study is effective in improving blood pressure levels in patients with hypertension in community.In addition,it can improve the quality of life of patients to a certain extent and is highly safe,which can be recommended in the adjuvant treatment for patients with hypertension.Moreover,taking medicine and food homologous as tea can increase the richness and diversity of gut microbiota in patients with hypertension in community,significantly increases the abundance of butyric acid-producing bacteria(Clostridium,Anaerostipes)and beneficial bacteria(Leuconostoc,Lactobacillus),and the abundance of Eubacterium and other genus in gut microbiota is related to blood pressure levels.It demonstrated that took medicine and food homologous as tea helps to restore healthy gut microbiota composition and structure that this effect may mediate the improvement of blood pressure.