Wang Y, Wang H, Howard AG, et al. - Since gut microbial and metabolic pathways of blood pressure (BP) regulation have been revealed in animal studies, researchers examined multivariable-adjusted (eg, diet, physical activity, smoking, kidney function), cross-sectional links between measures of gut microbiota, and plasma metabolome with systolic (SBP, mean [SD] = 126.0 [17.4] mm Hg) and diastolic BP (DBP [80.7 (10.7) mm Hg]) in a population-based, Chinese cohort who did not report antihypertension medication use (30–69 years, 54% women). The overall microbial community evaluated via principal coordinate analysis differed by SBP and DBP. A positive association of a lipid pattern with SBP and DBP was identified. Among 1,104 individual metabolites, 34 and 39 metabolites were found to be positively related to SBP and DBP, respectively, including linoleate, palmitate, dihomolinolenate, 8 sphingomyelins, 4 acyl-carnitines, and 2 phosphatidylinositols. In subsequent pathway analysis, metabolic pathways of long-chain saturated acylcarnitine, phosphatidylinositol, and sphingomyelins were shown to be related to SBP and DBP. These findings indicate potential roles of microbiota as well as metabolites in BP regulation to be followed up in prospective as well as clinical investigations.