Fig. 1

Interactions between blood pressure, sex and the microbiome across the life course. Adapted from Colafella et al. [6]. Compared to men (blue line), women (red line) are usually protected from an increase in blood pressure until they reach menopause. During reproductive years, men have higher BP than women; however, conditions such as PCOS, preeclampsia, obesity and autoimmune and inflammatory diseases, acting partly via the gut microbiome, elevate women’s BP to levels similar to, or greater than, men’s. In postmenopausal years, women’s BP increases sharply relative to men’s, driven by changes in sex hormone levels, alongside metabolic risk factors. Legend: BP, blood pressure; PCOS, polycystic ovarian syndrome