According to a new review published last month in Complimentary Therapies in Medicine, researchers investigated the potential benefits of Lactobacillus supplementation on blood pressure. Previous clinical trials have shown inconsistent results. Additionally, I recently shared research on the role of dysbiosis and probiotic supplementation on cardiovascular health and its impact on dyslipidemia.

The meta-analysis review consisted of 18 randomized controlled trials published between 2012 and 2018. These studies included between 28 and 164 participants for a 3- to 24-week period. As a result, Lactobacillus supplementation significantly reduced systolic blood pressure and diastolic blood pressure compared to the placebo. This was consistent with the results from a previous meta-analysis. This reduction was modest; however, even small reductions in blood pressure can significantly reduce stroke, myocardial infarction, and mortality.

An additional subgroup analysis demonstrated that patients with type 2 diabetes, patients of Asian descent, and patients with borderline hypertension had more significant effects from Lactobacillus supplementation. In addition, the effect of Lactobacillus supplementation on blood pressure was more significant when it was delivered in a capsule form with the dose >5 billion CFUs per day and a duration longer than 8 weeks. Furthermore, a subgroup analysis of Lactobacillus strains demonstrated that L. plantarum showed a slight decrease in blood pressure compared with other species.

Although, the underlying mechanisms of Lactobacillus on blood pressure have not been fully determined, animal studies have demonstrated Lactobacillus supplementation improves endothelial function, preventing vascular inflammation and oxidative stress. In addition, L. plantarum can inhibit angiotensin-converting enzyme (ACE) activity and produce nitric oxide in the gastrointestinal tract.

Probiotics help encourage microbial diversity, especially if the probiotic supplement is comprised of a mixed species. In ecological terms, it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome.

This study demonstrates that Lactobacillus supplementation >5 billion CFUs in capsule form given for more than 8 weeks has the potential to decrease systolic and diastolic blood pressure in patients with type 2 diabetes, borderline hypertensive patients, and Asian individuals. Previous meta-analyses showed similar findings with supplementation >100 billion CFUs.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Liu J, Zhang D, et al. The effect of Lactobacillus consumption on human blood pressure: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2020;54:102547. doi: 10.1016/j.ctim.2020.102547.