Association between oral microbiome diversity and hypertension in the US population

Background Population-based research on the relationship between oral microbiome diversity and hypertension risk remains limited. This study aims to investigate the relationship between oral microbiome diversity and hypertension. Methods We conducted a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data from 2009–2012. The association between oral microbiome α-diversity and hypertension risk was assessed using multivariable logistic regression models. Restricted cubic splines were employed to examine dose-response relationships. β-diversity differences between hypertensive and normotensive groups were evaluated using Principal Coordinate Analysis (PCoA) and Permutational Multivariate Analysis of Variance (PERMANOVA). Results Among 7,737 participants analyzed, observed amplicon sequence variants (ASVs) and Faith's phylogenetic diversity (Faith's PD) demonstrated significant inverse associations with hypertension risk. Compared to the lowest quartile, multivariable-adjusted odds ratios (ORs) for quartiles 2–4 were 0.821 (95% CI: 0.679–0.993), 0.780 (0.639–0.951), and 0.790 (0.640–0.974) for ASVs ( P  = 0.042, 0.014, and 0.027, respectively), and 0.833 (0.688–1.008), 0.755 (0.619–0.922), and 0.744 (0.604–0.916) for Faith's PD ( P  = 0.060, 0.006, and 0.005, respectively). β-diversity analysis revealed significant differences between hypertensive and normotensive groups across all distance metrics (Bray-Curtis, unweighted and weighted UniFrac; all P  < 0.01). Conclusion Significant disparities in oral microbiome α-diversity and β-diversity were identified between individuals with hypertension and those without. Notably, higher α-diversity, particularly observed ASVs and Faith's PD, exhibited a negative correlation with hypertension risk.