Gut Health & Cardiovascular Wellness: The Unexpected Connection

When we think about heart health, the usual advice comes to mind—eat less salt, exercise more, manage stress. But what if a major factor influencing cardiovascular health was something we rarely consider?

Your gut microbiome, the vast community of bacteria living in your digestive tract, plays a powerful role in cholesterol regulation, inflammation, and blood pressure—three critical markers of heart disease risk. Research increasingly shows that an imbalanced gut can contribute to conditions like blood pressure, atherosclerosis, and even heart attacks.

This connection might seem unexpected, but it makes sense when we look at how deeply intertwined our gut is with overall health. Certain gut bacteria influence cholesterol metabolism, while others produce inflammatory compounds that damage blood vessels. At the same time, an unhealthy gut can lead to a condition called leaky gut, allowing harmful substances to enter the bloodstream and trigger systemic inflammation—a key driver of heart disease.

In this blog, we’ll explore the science behind the gut-heart connection, uncover how your microbiome impacts cardiovascular function, and, most importantly, provide actionable steps to support both gut and heart health through diet and lifestyle.

The Microbiome’s Role in Cardiovascular Health

Your gut microbiome is home to trillions of bacteria, fungi, and other microbes that help break down food, produce essential nutrients, and regulate immune function. But their role doesn’t stop at digestion—these microbes also influence how your body processes cholesterol, controls inflammation, and maintains vascular health.

Here’s how your gut bacteria impact your cardiovascular system:

Microbial Metabolites and Their Effect on Heart Health

·      Your gut bacteria produce metabolites (small molecules that affect biological processes) that can either support or harm cardiovascular function.

·      Beneficial metabolites include short-chain fatty acids (SCFAs), like butyrate, which help regulate blood pressure and reduce inflammation.

·      Harmful metabolites, such as trimethylamine N-oxide (TMAO), have been linked to an increased risk of heart disease and stroke.

Dysbiosis: The Root of Gut-Heart Problems

·      A balanced microbiome contains a diverse range of beneficial bacteria, but modern diets high in processed foods, sugar, and unhealthy fats can disrupt this balance.

·      When harmful bacteria outnumber beneficial ones (a conditions known as dysbiosis), the gut starts producing more pro-inflammatory compounds that can damage blood vessels and contribute to hypertension and atherosclerosis.

·      Dysbiosis is also linked to elevated cholesterol levels, as some gut bacteria help break down and excrete cholesterol while others promote its reabsorption into the bloodstream.

Gut Barrier Function and Systemic Inflammation

·      A healthy gut lining acts as a barrier, keeping toxins and harmful microbes out of the bloodstream.

·      If this barrier is compromised (a condition often linked to leaky gut), bacterial toxins like lipopolysaccharides (LPS) can enter circulation, triggering widespread inflammation and contributes to high blood pressure and arterial plaque buildup.

·      Chronic low-grade inflammation is a major driver of cardiovascular disease, and an unhealthy gut can be a significant contributor.

The Gut-Immune System Connection

·      Approximately 70% of your immune system resides in your gut.

·      A disrupted microbiome can lead to an overactive immune response, resulting in persistent inflammation that affects both gut and heart health.

·      Supporting gut health with anti-inflammatory foods and probiotics ca help modulate immune activity and lower cardiovascular risk.

Maintaining a balanced microbiome is essential for keeping inflammation in check, supporting healthy blood vessels, and reducing cardiovascular risk. But one of the most direct ways your gut influences heart health is through cholesterol metabolism—where certain gut bacteria help regulate cholesterol levels, while others may contribute to imbalances that increase heart disease risk.

Let’s dive deeper into how your gut microbiome affects cholesterol absorption, bile acid metabolism, and overall lipid balance.

Gut Bacteria and Cholesterol Metabolism

Cholesterol is often viewed as a villain in heart health, but in reality, it plays essential roles in hormone production, cell membrane integrity, and digestion. The key isn’t eliminating cholesterol—it’s ensuring that your body processes it efficiently and maintains a healthy balance between LDL (low-density lipoprotein, or “bad” cholesterol) and HDL (high-density lipoprotein, or “good” cholesterol). While diet and genetics influence cholesterol levels, an often-overlooked factor is the gut microbiome.

Your gut bacteria help regulate cholesterol metabolism in several ways, affecting how much cholesterol is absorbed, synthesized, and excreted. A well-balanced microbiome can support healthy cholesterol levels, while an imbalanced one may promote high LDL cholesterol, low HDL cholesterol, and increased cardiovascular risk.

How Gut Bacteria Influence Cholesterol Levels

One of the key ways the gut microbiome impacts cholesterol is through bile acid metabolism. Bile acids are substances produced by the liver that help digest fats. After aiding in fat digestion, bile acids are reabsorbed in the intestines or broken down by gut bacteria. Some beneficial gut bacteria, such as Lactobacillus and Bifidobacterium, help transform bile acids into forms that promote cholesterol excretion rather than reabsorption. This means that a well-functioning microbiome can help prevent cholesterol buildup in the bloodstream.

On the other hand, an unhealthy gut can disrupt this process. When dysbiosis (an imbalance in gut bacteria) occurs, fewer beneficial bacteria are available to aid in bile acid metabolism. This results in greater cholesterol reabsorption, which can contribute to elevated LDL cholesterol levels.

Another way the microbiome regulates cholesterol is by influencing cholesterol synthesis in the liver. Some gut bacteria produce compounds called short-chain fatty acids (SCFAs), particularly butyrate, acetate, and propionate, which can help regulate cholesterol production. Propionate, in particular, has been shown to inhibit cholesterol synthesis in the liver, helping to lower LDL cholesterol naturally.

Dysbiosis and Its Role in Cholesterol Imbalance

When gut health is compromised, the effects on cholesterol metabolism can be significant. Studies have found that certain bacterial strains are linked to increased cholesterol absorption and LDL production. For example, some bacteria promote the formation of secondary bile acids, which are less efficient at eliminating cholesterol from the body. Over time, this can lead to higher LDL levels and a greater risk of plaque buildup in arteries—a condition known as atherosclerosis.

Additionally, an unhealthy gut may contribute to low HDL cholesterol levels. HDL is crucial because it acts like a scavenger, removing excess cholesterol from the bloodstream and transporting it to the liver for disposal. Some beneficial gut bacteria help boost HDL production, while an imbalanced microbiome may reduce its levels, making it harder for the body to clear excess cholesterol.

Can Probiotics Help Regulate Cholesterol?

Research shows that certain probiotics can support healthy cholesterol levels by promoting bile acid breakdown, increasing SCFA production, and reducing cholesterol absorption. Strains such as Lactobacillus reuteri and Bifidobacterium longum have been shown to help lower LDL cholesterol and raise HDL cholesterol naturally. These probiotic strains are found in fermented foods like yogurt, kefir, sauerkraut, and kimchi, as well as in high-quality probiotic supplements.

While probiotics alone aren’t a cure-all, they can play a supportive role in a cholesterol-friendly diet. When combined with fibre-rich foods, healthy fats, and a balanced microbiome, they help create an environment that optimizes cholesterol metabolism and reduces cardiovascular risk.

A disrupted gut microbiome doesn’t just influence cholesterol-it also plays a role in the production of harmful compounds like trimethylamine N-oxide (TMAO), which has been directly linked to an increased risk of heart disease. In the next section, we’ll explore how TMAO is formed, why it’s problematic, and how gut health strategies ca help reduce its impact.

TMAO: The Gut-Heart Risk Factor

One of the most concerning ways the gut microbiome influences cardiovascular health is through the production of trimethylamine N-oxide (TMAO)-- a compound that has been directly linked to an increased risk of heart disease, stroke, and arterial plaque buildup. Unlike cholesterol, which can be managed through a combination of dietary and lifestyle changes, TMAO presents a unique challenge because its production is driven by gut bacteria.

Understanding how TMAO is formed and its impact on the cardiovascular system is crucial for developing gut-friendly strategies to reduce its harmful effects.

How is TMAO Formed?

TMAO originated from certain dietary compounds—primarily choline, L-carnitine, and betaine—which are found in foods like red meat, eggs, dairy, and some seafoods. When these compounds enter the gut, specific bacteria convert them into trimethylamine (TMA). TMA is then absorbed into the bloodstream and transported to the liver, where it is converted into TMAO.

This process itself isn’t inherently harmful. However, elevated TMAO levels have been consistently associated with increased cardiovascular risk, particularly due to their effects on arterial health, blood clot formation, and inflammation.

The Cardiovascular Risks of High TMAO Levels

Research has linked high TMAO levels to several mechanisms that promote heart disease:

Increased Arterial Plaque Formation

·      TMAO has been shown to enhance the uptake of cholesterol into artery walls, contributing to the formation of atherosclerotic plaques.

·      Over time, these plaques can narrow blood vessels, increasing the risk of heart attacks and strokes.

Enhanced Blood Clotting (Thrombosis Risk)

·      TMAO appears to promote platelet aggregation, meaning it makes blood more likely to clot.

·      This increases the risk of dangerous clots forming in the arteries, potentially leading to life-threatening conditions such as deep vein thrombosis, pulmonary embolism, or strokes.

Increased Systemic Inflammation

·      High TMAO levels have been linked to elevated inflammatory markers, such as C-reactive protein (CRP)

·      Chronic inflammation is a key driver to cardiovascular disease, as it contributes to vascular damage, insulin resistance, and hypertension.

Not All Gut Bacteria Produce TMAO

Interestingly, not all gut microbiomes produce high amounts of TMAO. The presence of specific bacterial strains determines whether a person is at risk for excessive TMAO production. Studies show that individuals with a gut microbiome rich in certain Firmicutes bacteria tend to produce more TMAO, whereas a microbiome dominated by Bacteroidetes and beneficial Lactobacillus species may produce lower levels of TMAO.

This means that gut diversity and balance play a critical role in whether or not TMAO becomes a problem for cardiovascular health.

How to Reduce TMAO Production Naturally

While eliminating all TMAO-producing foods isn’t necessary, modifying the diet and improving gut health can help lower TMAO levels and protect heart health.

Eat More Fibre-Rich Foods

·      Fibre helps feed beneficial gut bacteria that don’t produce TMAO and promotes microbial diversity.

·      Foods rich in prebiotic fibre—such as onions, garlic, leeks, and asparagus—support a healthier gut environment.

Limit Red Meat and Processed Meat Consumption

·      Reducing the intake of beef, pork, and lamb, as well as processed meats like bacon and sausage, can significantly lower TMAO production.

·      Instead, opt for fish, lean poultry or plant-based proteins as more heart-friendly options.

Incorporate More Polyphenols

Polyphenol-rich foods—such as berries, green tea, dark chocolate, and olive oil—have been shown to inhibit TMA-producing bacteria and reduce TMAO levels.

Consider Probiotic and Prebiotic Support

·      Certain probiotic strains, particularly Lactobacillus and Bifidobacterium species can help balance the microbiome and reduce the number of TMA-producing bacteria.

·      Prebiotics (like resistant starch and inulin) can promote beneficial bacteria that don’t contribute to TMAO formation.

Support Liver Detoxification

·      Since TMA is converted into TMAO in the liver, supporting liver function with nutrients like B vitamins, glutathione, and milk thistle can help regulate this process.

While TMAO is an emerging risk factor for heart disease, its production isn’t set in stone—gut health and dietary choices play a major role in determining TMAO levels. However, TMAO is just one part of the gut-heart connection. Another major factor influencing cardiovascular wellness is chronic inflammation—often driven by a disrupted gut barrier and an overactive immune system.

In the next section, we’ll explore how gut health impacts inflammation, blood pressure, and overall heart function—and what you can do to keep inflammation under control.

The Inflammation Connection: How Gut Health Impacts Blood Pressure & Arterial Health

Inflammation is at the core of nearly all chronic diseases, including cardiovascular disease. While some inflammation is a normal immune response to injury or infection, chronic, low-grade inflammation is a different story—it silently damages tissues over time, contributing to hypertension, arterial stiffness, and plaque buildup in blood vessels.

What many people don’t realize is that gut health plays a significant role in regulating inflammation. When the gut microbiome is imbalanced, or the intestinal lining is compromised, inflammatory signals can spread throughout the body, affecting the heart, blood vessels, and even blood sugar regulation.

Leaky Gut: A Hidden Driver of Systemic Inflammation

A healthy gut lining acts as a protective barrier, ensuring that nutrients are absorbed while keeping harmful bacteria, toxins, and undigested food particles out of the bloodstream. But when the integrity of this barrier is weakened—a condition known as intestinal permeability, or “leaky gut”—undesirable compounds can slip through and trigger an immune response.

One of the most concerning byproducts of leaky gut is lipopolysaccharides (LPS), toxic fragments from the outer membranes of certain gut bacteria. When LPS enters the bloodstream, it sets off a cascade of inflammation, stimulating immune cells to release pro-inflammatory cytokines such as TNF-alpha, IL-6, and CRP (C-reactive protein)—all of which are strongly linked to heart disease and hypertension.

·      LPS has been found in high levels in people with atherosclerosis (hardened arteries) and has been shown to contribute to the progression of heart disease.

·      Chronic exposure to LPS can impair blood vessel function, leading to high blood pressure and arterial stiffness.

·      Individuals with dysbiosis (imbalanced gut bacteria) often have higher levels of LPS and inflammatory markers, further amplifying cardiovascular risk.

The Gut’s Role in Blood Pressure Regulation

Beyond inflammation, the gut microbiome also influences blood pressure regulation in surprising ways. Certain gut bacteria produce short-chain fatty acids (SCFAs), particularly butyrate, acetate, and propionate, which play a role in:

·      Relaxing blood vessels (vasodilation), helping to lower blood pressure.

·      Regulating the renin-angiotensin system (RAS), a key hormonal system that controls blood pressure balance.

·      Reducing oxidative stress, which can contribute to arterial damage.

When the microbiome is diverse and balanced, SCFA production is optimized, and blood vessels remain flexible and responsive. But in cases of gut dysbiosis, a decline in SCFA-producing bacteria can lead to higher blood pressure, increased inflammation, and stiffened arteries—all major risk factors for heart disease.

How to Reduce Gut-Driven Inflammation & Support Cardiovascular Health

Because inflammation is a key driver of heart disease, taking steps to improve gut health can have direct benefits for cardiovascular wellness. Here’s how:

Heal the Gut Barrier

·      Incorporate gut-healing nutrients like L-glutamine, zinc, collagen, and omega-3 fatty acids, which help strengthen intestinal lining integrity.

·      Reduce processed foods, alcohol, and excessive sugar, which can further damage the gut barrier.

Increase SCFA Production

·      Eat more fibre-rich, prebiotic foods like onions, garlic, asparagus, and bananas, which feed SCFA-producing bacteria.

·      Include fermented foods (such as kimchi, sauerkraut, and kefir) that introduce beneficial probiotics to enhance gut balance.

Lower LPS & Inflammatory Load

·      Consume polyphenol-rich foods like green tea, blueberries, and turmeric, which can reduce gut-derived inflammation and support vascular health.

·      Consider a high-quality probiotic to help crowd out pro-inflammatory bacteria that contribute to LPS production.

Balance the Renin-Angiotensin System (RAS)

Research suggests that certain gut bacteria can modulate the RAS system, influencing blood pressure control. Eating a diverse range of plant-based foods encourages a microbiome that supports healthy blood pressure levels.

The bottom line? Chronic inflammation stemming from an unhealthy gut can contribute to high blood pressure, arterial damage, and increased heart disease risk. But by nourishing your gut with the right foods, lifestyle habits, and gut-supporting nutrients, you can reduce inflammation, support healthy circulation, and protect your heart.

Next we’ll explore specific, actionable gut-health strategies that can optimize cardiovascular wellness—helping you take control of both your digestive and heart health.

Gut Health Strategies for a Stronger Heart

Now that we’ve established how gut health influences cholesterol metabolism, inflammation, and blood pressure, the next step is understanding how to optimize your microbiome for better cardiovascular health. The good news? Small, strategic changes to your diet and lifestyle can positively shift your gut bacteria, reduce harmful metabolites like TMAO, and support heart-protective pathways.

Below are the most effective ways to enhance gut health while promoting better cardiovascular function.

Eat More Fibre-Rich, Prebiotic Foods

Fibre is one of the most important nutrients for gut and heart health. It feeds beneficial gut bacteria, supports cholesterol metabolism, and reduces inflammation—all while helping to regulate blood sugar and blood pressure.

·      Soluble fibre (found in oats, flaxseeds, beans, and apples) binds to cholesterol in the intestines, helping to eliminate excess LDL from the body.

·      Insoluble fibre (from vegetables, whole grains, and nuts) supports digestion and gut motility, preventing constipation and toxin buildup.

·      Prebiotic fibre (from onions, garlic, asparagus, and bananas) selectively feeds beneficial bacteria that produce heart-protective compounds like SCFAs.

Aim for at least 25-30g of fibre per day to maintain gut balance and cardiovascular health.

Support Your Gut Microbiome With Probiotic & Fermented Foods

A diverse gut microbiome is key to reducing inflammation and maintaining heart health. Probiotics introduce beneficial bacteria that help balance cholesterol, reduce TMAO production, and lower systemic inflammation.

Best probiotic foods for gut and heart health:

·      Fermented vegetables: Sauerkraut, kimchi, pickles

·      Dairy-based probiotics: Kefir, yogurt (unsweetened, live cultures)

·      Other fermented foods: Miso, tempeh, natto

If you struggle to get enough probiotics through food, consider a high-quality probiotic supplement containing Lactobacillus and Bifidobacterium strains—both shown to support cholesterol balance and gut health.

Reduce Processed & Pro-Inflammatory Foods

Certain foods disrupt gut bacteria, promote TMAO production, and contribute to inflammation—all of which increased the risk of heart disease.

Limit or avoid:

·      Ultra-processed foods high in refined sugars, artificial additives, and trans fats

·      Excess red meat & processed meats (bacon, deli meats, hot dogs), which can increase TMAO levels

·      High-sugar foods & beverages that promote gut dysbiosis and inflammation

Instead, prioritize whole, anti-inflammatory foods rich in antioxidants, fibre, and healthy fats.

Prioritize Polyphenol-Rich Foods

Polyphenols are powerful plant compounds that feed beneficial gut bacteria, reduce oxidative stress and lower inflammation. They also help regulate cholesterol levels and reduce blood vessel damage.

Best polyphenol-rich foods for gut and heart health:

·      Berries (blueberries, raspberries, blackberries)

·      Dark chocolate (85% or higher)

·      Olive oil & green tea

·      Turmeric & ginger

Incorporate a variety of these foods daily to support both microbiome diversity and cardiovascular function.

Optimize Omega-3 Fatty Acids for Gut & Heart Benefits

Omega-3 fatty acids are well-known for their anti-inflammatory properties and heart-protective effects, but they also play a role in supporting gut barrier function.

·      EPA & DHA (found in fatty fish, like salmon, sardines, and mackerel) help reduce systemic inflammation and support gut integrity.

·      ALA (found in flaxseeds, chia seeds, and walnuts) provides plant-based omega-3s that contribute to a balanced gut microbiome.

Aim for 2-3 servings of omega-3-rich fish per week or supplement with a high-quality fish oil.

Manage Stress & Support Gut-Heart Axis

Chronic stress disrupts the gut microbiome, increases inflammation, and contributes to high blood pressure and cardiovascular strain. The gut and brain communicate constantly, meaning stress directly impacts both digestive and heart health.

Effective ways to reduce gut-driven stress:

·      Practice mindfulness and meditation (shown to support both gut microbiome and heart rate variability)

·      Prioritize sleep (poor sleep disrupts gut bacteria & raises inflammation)

·      Engage in daily movement (yoga, walking, resistance training all benefit gut health)

Incorporate stress-reducing habits into your routine to keep inflammation levels low and protect both your gut and heart.

Conclusion

The connection between gut health and cardiovascular wellness is stronger than most people realize. From cholesterol metabolism to inflammation control, blood pressure regulation, and arterial health, your gut microbiome plays a critical role in protecting your heart.

Good news? By making simple, science-backed changes to your diet and lifestyle, you can improve gut balance, reduce cardiovascular risk, and take control of your overall well-being.

If you’re looking for personalized support to improve gut and heart health, I offer customized nutrition plans and functional testing to help uncover imbalances and create a strategy tailored to your needs.

Book your free discovery call today to start optimizing your gut for long-term cardiovascular wellness!