Abstract Body: Introduction:
Hypertension remains a leading modifiable risk factor for various cardiovascular diseases. An emerging body of evidence highlights the gut microbiome's role in hypertension, yet the therapeutic potential of fecal microbiota transplantation (FMT) in its management is not well-established. This meta-analysis was conducted to systematically evaluate the impact of FMT on primary hypertension.

Methods:
A systematic literature search was conducted across PubMed/MEDLINE, Scopus, Science Direct, and clinical trial registries (clinicaltrials.gov), adhering to PRISMA guidelines. Studies reporting the effect of FMT on primary hypertension, specifically changes in systolic (SBP) or diastolic blood pressure (DBP), were included. Data were analyzed in RevMan 5.4.1. using continuous random-effects models, with statistical significance defined as p ≤ 0.05.

Results:
The analysis included five studies with a total of 304 patients, of whom 149 (49%) received FMT. Patients who received FMT had a significantly greater reduction of SBP (MD -3.34; 95% CI -6.64, -0.05; p=0.05) and DBP (MD -2.58; 95% CI -4.57, -0.60; p=0.01) compared to placebo (Figure 1).

Conclusion:
In conclusion, FMT may offer a potential therapeutic avenue for lowering blood pressure in patients with primary hypertension. Further research, including larger, well-designed clinical trials, is warranted to confirm these findings and elucidate the underlying mechanisms.