Can gut microbiota-supportive dietary patterns mitigate hypertension risk? Evidence from a national survey

Emerging evidence underscores the role of gut microbiota as a critical regulator of cardiometabolic health, particularly in blood pressure modulation. Although dietary habits are known to influence microbial diversity and function, the association between microbiota-supportive dietary patterns and hypertension remains insufficiently characterized. This study aimed to investigate the relationship between adherence to the Dietary Index for Gut Microbiota (DI-GM) and the prevalence of hypertension. We analyzed data from 20,905 participants in the 2010–2020 cycles of the National Health and Nutrition Examination Survey (NHANES). The DI-GM was derived from 14 dietary components either beneficial or detrimental to gut microbial balance. Multivariable logistic regression and restricted cubic spline models were employed to explore associations between DI-GM scores and hypertension. A higher DI-GM score was consistently associated with a lower likelihood of hypertension across all adjusted models. Compared to individuals with scores between 0 and 3, those scoring 6 or higher exhibited significantly reduced odds of hypertension (adjusted OR = 0.73; 95% CI 0.66–0.78). This inverse association was robust across all examined subgroups, with no statistically significant interactions detected. Greater adherence to gut microbiota-supportive dietary patterns, as reflected by higher DI-GM scores, was associated with a lower prevalence of hypertension among U.S. adults. These findings support the potential utility of microbiome-informed nutritional strategies in hypertension prevention and management.