Tongue-coating microbiome reflects cardiovascular health and determines outcome in blood pressure intervention.

Tongue-coating microbiome,as a part of oral microbiome,is an important part of commensal microbes in human body.Despite tech-nical difficulties in gaining functional insights using metagenomic ap-proaches due to high levels of host DNA contaminations,a number of diseases have been found to be closely related to the alteration of oral microbial communities,including periodontal and caries dis-eases,cardiovascular disease,diabetes,rheumatoid arthritis,and cancer(Gao et al.,2018;Irfan et al.,2020;Kleinstein et al.,2020;Willis and Gabaldon,2020).Particularly for tongue-coating micro-biome,its role in maintaining cardiovascular wellness has recently gained significant attention(Avery et al.,2021).Altered tongue-coating microbe composition has been revealed in the high blood pressure population(Barbadoro et al.,2021;LaMonte et al.,2022),and the potential mechanisms involved the blood vascular relaxing factors NO(Bondonno et al.,2016)and H2S(Zhang et al.,2018)pro-duced by oral microbes.However,the attempts to decrease high blood pressure by supplementation of nitrate or nitrate containing food were not satisfactory(Kapil et al.,2015;Blekkenhorst et al.,2018).