A Preliminary Study on the Value of Intestinal Flora in Predicting Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Refractory Hypertension

OBJECTIVE: To investigate the value of intestinal flora in predicting major adverse cardiovascular and cerebrovascular events (MACCE) in patients with refractory hypertension (RH). METHODS: 359 patients with RH hospitalized in our hospital from April 2020 to March 2021 were followed up for 1 year and selected for the study. These patients were divided into a MACCE group and no-MACCE group. Results were analyzed by comparing general information, the abundance of intestinal flora at the phylum level, and the abundance of intestinal flora at the species level between the two groups. The influence factors related to MACCE were evaluated using multifactor logistic regression analysis, and the value of intestinal flora in predicting MACCE was determined using receiver operating characteristic (ROC) and the area under ROC (AUC). RESULTS: Systolic blood pressure was higher in the MACCE group than in the no-MACCE group (P < 0.05). The abundances of Actinomycetes and Verrucomicrobia were higher in the MACCE group than in the no-MACCE group, while unnamed viruses were the opposite (P < 0.05). The abundances of Eubacterium eligens, Akkermansia muciniphila, Prevotella stercorea, and Eubacterium rectale were lower in the MACCE group than in the no-MACCE group, while Escherichia coli, Clostridium hathewayi, and Ruminococcus gnavus were opposite (P < 0.05). Systolic blood pressure, Actinomycetes, unnamed viruses, Verrucomicrobia, Eubacterium eligens, Akkermansia muciniphila, Prevotella stercorea, Eubacterium rectale, Escherichia coli, Clostridium hathewayi, and Ruminococcus gnavus were closely associated with MACCE in RH patients (P < 0.05). In addition, Akkermansia muciniphila had the highest AUC among the single indicator but was still lower than the AUC of the combined detection. CONCLUSION: The increases of Actinomycetes, Verrucomicrobia, Escherichia coli, Clostridium hathewayi, and Ruminococcus gnavus and the decreases of unnamed viruses, Eubacterium eligens, Akkermansia muciniphila, Prevotella stercorea, and Eubacterium rectale were associated with MACCE in RH patients, and the combined detection may provide a method and idea for predicting and preventing MACCE.