Cardiovascular disease is the global leading cause of mortality. The underlying pathology of atherosclerosis is behind many cardiovascular diseases. Atherosclerosis is a multifactorial process that involves an inflammatory response, macrophage to foam cell transformation, plaque formation, and deleterious changes to the function of the vascular endothelium. Recent literature has explored the role of beneficial microbes in support of the potential prevention of certain atherosclerotic changes. 

Research indicates that the composition of the gut microbiome may differ in individuals with atherosclerotic changes. Certain researchers have referred to the bidirectional relationship between the gut microbiome and the heart as the “gut-heart axis.” The abundance of certain microbes (including those in the Bacteroides, Lactobacillus, and Clostridium genera) have been linked to certain predictors of coronary artery disease. In one clinical study, the gut microbiome of individuals with coronary atherosclerosis was shown to have significant compositional differences when compared with healthy individuals. These downstream implications may include changes in the amount of metabolites produced by microorganisms. Microbial metabolites (such as short-chain fatty acids) have been linked to certain protective effects regarding cardiovascular outcomes.

A recently published review by Zhai and colleagues investigated the relationship between probiotics and the prevention of certain atherosclerotic changes. Animal studies reported in this review reported effects including decreases in tumor necrosis factor-α (TNF-α), low-density lipoprotein, total cholesterol, and overall atherosclerotic preventive effects in the presence of Bifidobacterium adolescentis, Lactobacillus acidophilus ATCC4356, and L. paracasei. 

Clinical studies reported similar results in the potential supportive role of probiotics in relation to atherogenic changes. A study involving B. animalis subs. Lactis reported an increase in endothelial function and decreases in triglycerides, total cholesterol, and C-reactive protein. Another study involving the combined administration of L. acidophilus, L. reuteri, L. fermentum, and B. bifidum reported increased total antioxidant capacity and total glutathione. A randomized, placebo-controlled, 12-week trial involving species from the Bifidobacterium, Lactobacillus, Lactococcus, Streptococcus, and Enterococcus genera reported reductions in tumor necrosis factor-alpha, thrombomodulin, systolic blood pressure, and interleukin-6 with greater effect at the higher amount of 10 billion colony forming units (CFUs) daily. 

The authors conclude that probiotics may help support cardiovascular health and help mitigate certain aspects of atherogenic risk factors. This may be due to the potential for probiotics to help modulate certain pro-inflammatory cytokines, help support microbiota homeostasis, and macrophage polarization. The authors acknowledge a current correlative relationship between probiotics and their potential cardiovascular actions. More research is needed before conclusions can be made, and therefore, future research is warranted.

Probiotics may help support many aspects of health including digestive function and the gut-brain axis. Recent research suggests that probiotics may also play a role in certain aspects of cardiovascular health. 

By Colleen Ambrose, ND, MAT