Because most cardiovascular diseases are chronic in nature, there is a growing recognition that this is very closely related to our lifestyle and metabolism. It is therefore often referred to as cardiometabolic diseases. We have explored the coherence for you.

It may not be obvious to everyone to put cardiovascular disease under the heading metabolic diseases. The reason for this classification is that the risk of cardiovascular disease and the associated risk factors play an important role in metabolic syndrome and is therefore referred to as cardiometabolic diseases (1). There are several factors related to cardiovascular disease, including high blood pressure, a disturbed lipid profile in the blood, atherosclerosis, and systemic inflammation, and there are several indications that suggest a relationship with the microbiome. For example, patients with inflammatory bowel disease have a greater risk of cardiovascular events, despite the fact that they are less likely to have 'classic' risk factors for cardiovascular disease, which indicates a link between gut and heart (2). It is also known that inflammatory reactions are involved in atherosclerosis and that the microbiome influences this (3,4), and that in patients with established atherosclerosis, the composition of the microbiome was more pro-inflammatory compared to healthy subjects (3). Such inflammatory reactions are attributed to bacterial substances that unintentionally enter the blood, which can be the result of increased permeability of the intestinal wall (the so-called 'leaky gut'). In this light, it is striking that in a study more bacterial and viral DNA was found in the blood of patients with various cardiovascular diseases than in healthy control subjects (5). In patients with high blood pressure, the composition and diversity of the microbiome also appears to differ from healthy individuals (6). Moreover, a 'faecal transplant' from those patients to laboratory animals results in a much higher blood pressure in the laboratory animals than a 'faecal transplant' from healthy individuals (6). In studies with probiotic supplementation, an improved lipid profile and reduced blood pressure are found in patients (1,4,7). Finally, in addition to the gut microbiome, the oral microbiome is also an interesting factor in cardiovascular disease. For example, there is a known correlation between periodontal disease and cardiovascular disease, and several studies show that probiotics can positively affect the oral microbiome and, for example, dental plaque, which may help lower the risk of cardiovascular disease (7).