Why physicians should be cautious prescribing antibiotics to hypertensive patients

Researchers are cautioning physicians to be wary when prescribing antibiotics to hypertensive patients after a study published in Physiological Genomics found individual genetic makeup can significantly affect how a person’s blood pressure reacts to common drugs like vancomycin and minocycline.

The study, led by first author Sarah Galla and a team at the University of Toledo College of Medicine and Life Sciences, focused on gut microbiota, a collection of bacteria that populate the gastrointestinal tract and are as unique to each person as their genes. Each patient’s gut microbiota is diverse and plays a role in both maintaining health and the development of disease, Galla et al. explained, meaning antibiotics that kill harmful gut bacteria could also be eliminating helpful ones.

In an effort to determine how individual microbiota react to everyday antibiotics, the research team treated two groups of hypertension-prone rats orally with vancomycin, minocycline and neomycin. One cohort of animals, known as Dahl salt-sensitive rats, were at risk for high blood pressure due to a high-salt diet, while the other cohort, spontaneously hypertensive rats (SHRs), were at an increased risk for reasons unrelated to diet.

Each group reacted to the medications differently, the authors said, including in the way individual rats’ blood pressures reacted to the drugs. Minocycline and neomycin increased systolic blood pressure in Dahl rats, though vancomycin didn’t elicit the same reaction. SHR rats treated with any of the antibiotics saw either a drop in systolic blood pressure or no change at all.

“These disparate blood pressure effects were accompanied by significant alterations in gut microbiota,” Galla and colleagues wrote in the journal. “Our study highlights the need to consider an individualized approach for the usage of antibiotics among hypertensives, as their BP could be affected differentially based on their individual genetic and microbiotal communities.”

The authors said their work highlights the importance of continued study in this area.

“This raises the question of safety in the usage of antibiotics by patients with such modern ailments [as hypertension],” they wrote.

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After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.

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