The aetiopathogenesis of cardiovascular diseases (CVD) is multifactorial. Adverse blood
pressure (BP) is a major independent risk factor for epidemic CVD affecting about 40% of the
adult population worldwide and resulting in significant morbidity and mortality. Metabolic
phenotyping of biological fluids has proven its application in characterisin
g low molecule
weight metabolites providing novel insights into gene
-environmental
-gut microbiome
interaction in relations to a disease state. In this review, we synthesi
s
e key results from the
International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) Study, a cross
-
sectional epidemiological study of 4,680 men and women aged 40
-59 years from Japan, the
People’s Republic of China, the United Kingdom, and the United States. We describe the
advancements we have made on: 1) analytical techniques for high throughput metabolic
phenotyping; 2) statistical analyses for biomarker identification; 3) discovery of unique food
-
specific biomarkers; and 4) application of metabolome
-wide association (MWA) studies to
gain a better understanding into the molecular mechanisms of cross cultural and regional BP
differences.