Non‐differential gut microbes contribute to hypertension and its severity through co‐abundances: A multi‐regional prospective cohort study

Abstract Microbial dysbiosis, characterized by an imbalanced microbial community structure and function, has been linked to hypertension. While prior research has primarily focused on differential abundances, our study highlights the role of non‐differential microbes in hypertension. We propose that non‐differential microbes contribute to hypertension through their ecological interactions, as defined by co‐abundances (pairs of microbes exhibiting correlated abundance patterns). Using gut microbiome data from the Guangdong Gut Microbiome Project, which includes 2355 hypertensive and 4644 non‐hypertensive participants across 14 regions, we identified replicable hypertension‐related microbial interactions. Notably, most co‐abundances involved non‐differential microbes, which were found to correlate with both hypertension severity and hypertension‐related microbial metabolic pathways. These findings emphasize the importance of microbial interactions in hypertension pathogenesis and propose a novel perspective for microbiome‐based therapeutic strategies.