| Summary: | Dysbiosis of gut microbiota (GM) has been involved in the pathophysiology of arterial hypertension (HT), via a putative role of short chain fatty acids (SCFAs). Its role in the circadian regulation of blood pressure (BP), also called “the dipping profile”, has been poorly investigated. Sixteen male volunteers and 10 female partners were subjected to 24 h ambulatory BP monitoring and were categorized in normotensive (NT) versus HT, as well as in dippers versus non-dippers. Nuclear magnetic resonance (NMR)-based metabolomics was performed on stool samples. A 5-year comparative follow-up of BP profiles and stool metabolomes was done in men. Significant correlations between stool metabolome and 24 h mean BP levels were found in both male and female cohorts and in the entire cohort (R<sup>2</sup> = 0.72, R<sup>2</sup> = 0.79, and R<sup>2</sup> = 0.45, respectively). Multivariate analysis discriminated dippers versus non-dippers in both male and female cohorts and in the entire cohort (Q<sup>2</sup> = 0.87, Q<sup>2</sup> = 0.98, and Q<sup>2</sup> = 0.68, respectively). Fecal amounts of acetate, propionate, and butyrate were higher in HT versus NT patients (<i>p</i> = 0.027; <i>p</i> = 0.015 and <i>p</i> = 0.015, respectively), as well as in non-dippers versus dippers (<i>p</i> = 0.027, <i>p</i> = 0.038, and <i>p</i> = 0.036, respectively) in the entire cohort. SCFA levels were significantly different in patients changing of dipping status over the 5-year follow-up. In conclusion, stool metabolome changes upon global and circadian BP profiles in both genders.
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