Specific gut bacteria may signal long-term risk of heart and metabolic disease

By Admin

10 Mar, 2026

The human gut contains trillions of microorganisms that influence many aspects of health, from digestion to immunity. Increasing scientific evidence now suggests that the gut microbiome may also play an important role in long-term heart and metabolic health. A recent study published in the journal npj Biofilms and Microbiomes has identified several gut bacteria that could signal a higher or lower risk of developing cardiovascular and metabolic diseases over time.

The findings provide new insight into how gut microbes, dietary habits, and metabolic health are interconnected, highlighting the potential of microbiome-based strategies for early disease prevention.

Growing Evidence Linking the Gut Microbiome and Heart Health

Researchers have long suspected that the gut microbiome influences cardiometabolic health. Studies using animal models and fecal microbiota transplantation have demonstrated that gut microbes can affect processes such as atherosclerosis and insulin resistance.

Certain microbial metabolites especially short-chain fatty acids (SCFAs) play a key role in regulating blood sugar levels, appetite, and blood pressure. Clinical trials have shown that these compounds may help improve metabolic health and reduce cardiovascular risk.

However, much of the earlier research relied on cross-sectional studies that capture only a snapshot of microbiome composition at a single point in time. Long-term human studies examining how gut bacteria influence future disease risk have been limited.

Large Prospective Study Examines Long-Term Risk

To better understand these long-term effects, researchers conducted a large prospective cohort study analyzing whether gut microbiome composition could predict cardiometabolic disease outcomes.

The study included 4,792 adults from the Healthy Life in an Urban Setting (HELIUS) study conducted between 2011 and 2015. Participants had not used antibiotics prior to sample collection, which helped ensure accurate microbiome analysis.

Researchers analyzed fecal samples using 16S ribosomal RNA sequencing to determine microbial composition. In a smaller subgroup of 105 participants, blood samples were analyzed using ultra-high-performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) to identify circulating metabolites linked to gut microbes.

Participants were followed for up to 9.5 years, with an average follow-up period of 6.2 years. During this time, researchers tracked the development of:

• Hypertension
  
  

• Diabetes
  
  

• Dyslipidemia (abnormal cholesterol levels)
  
  

• Major adverse cardiovascular events (MACE)
  
  

Hospital records and mortality registries from 2011 to 2024 were used to identify cardiovascular outcomes, including heart attacks, arrhythmia, heart failure, and cardiovascular deaths.

Study Population and Disease Outcomes

The study population consisted mostly of middle-aged adults with an average age of 50 years, and 53% of participants were women. Participants came from multiple ethnic backgrounds, including Dutch, African Surinamese, and South Asian Surinamese communities.

Over the follow-up period, researchers recorded:

• 376 cases of hypertension (21%)
  
  

• 375 cases of dyslipidemia (19%)
  
  

• 183 cases of diabetes (5.8%)
  
  

• 129 major cardiovascular events (MACE)
  
  

• 180 expanded cardiovascular events (MACE+)
  
  

The highest number of cardiovascular events occurred among South Asian Surinamese participants, although the strongest microbiome-disease associations were observed among Dutch and African Surinamese groups.

Gut Microbes Linked to Increased or Reduced Cardiovascular Risk

The researchers identified several bacterial species that appeared to influence cardiovascular risk.

Protective Microbes

Some gut bacteria were associated with a lower risk of cardiovascular events, including:

• Akkermansia muciniphila
  
  

• Lachnospiraceae family bacteria
  
  

• Eubacterium group species
  
  

Notably, one microbial group Eubacterium xylanophilum remained significantly protective even after adjusting for factors such as age, body mass index, smoking, and alcohol consumption. This suggests it may play an important role in maintaining cardiometabolic health.

Risk-Associated Microbes

Other microbes were linked to higher risk of metabolic diseases, including:

• Ruminococcus gnavus
  
  

• Flavonifractor plautii
  
  

• Streptococcus species
  
  

• Bifidobacterium (in hypertension analyses)
  
  

These microbes were associated with higher odds of developing conditions such as diabetes, dyslipidemia, and hypertension.

Microbial Diversity and Disease Risk

The study also examined overall microbial diversity in the gut using the Shannon diversity index and Bray-Curtis distance metrics.

Participants who later developed cardiometabolic diseases showed slightly lower microbial diversity, although these differences were modest and not strong predictors on their own.

More significant were the specific microbial species present in the gut, which showed clearer associations with disease risk.

Metabolites Reveal a Link Between Diet and Microbiome

The metabolomic analysis uncovered an interesting connection between gut microbes and diet.

Microbes associated with higher disease risk were linked to metabolites such as:

• Bile acids
  
  

• Acylcarnitines
  
  

In contrast, beneficial microbes were connected to plant-derived microbial metabolites, including:

• 3-phenylpropionate
  
  

• Cinnamoylglycine
  
  

• Enterolactone sulfate
  
  

These compounds are produced when gut bacteria metabolize plant-based foods, suggesting that dietary patterns particularly plant-rich diets may shape gut microbiota in ways that protect cardiovascular health.

What the Findings Mean for Future Prevention

The researchers concluded that gut microbiome composition may act as an early indicator of cardiometabolic disease risk, reflecting lifestyle factors such as diet.

Although the microbiome currently has limited diagnostic value, it may become a promising target for preventive strategies, including:

• Personalized nutrition plans
  
  

• Diets that promote beneficial gut bacteria
  
  

• Microbiome-focused therapies
  
  

The persistence of Eubacterium xylanophilum as a protective species after full statistical adjustment makes it a particularly interesting candidate for future research.

Study Limitations and Future Research

Despite the promising findings, the study has several limitations. The microbiome was measured only once at baseline, which limits the ability to determine cause-and-effect relationships.

Future research should include:

• Repeated microbiome measurements over time
  
  

• Larger metabolomic datasets
  
  

• Independent validation studies
  
  

• Controlled experimental studies
  
  

Such efforts could help scientists better understand how diet and microbiome interactions influence cardiovascular risk and guide more effective prevention strategies.

Conclusion

This large prospective study provides compelling evidence that specific gut bacteria may signal long-term risk for heart and metabolic diseases. While some microbes appear to increase disease risk, others particularly those linked to plant-based diets may offer protective benefits.

Although microbiome analysis is not yet ready for routine clinical diagnosis, it holds great potential for guiding future dietary interventions and preventive health strategies aimed at improving heart health through the gut microbiome.