Gut microbiota dysbiosis contributes to the development of hypertension. This study investigated the role of gut microbiota in hypertension by analyzing 196 participants, including 41 healthy controls, 56 pre-hypertensive (pHTN) individuals, and 99 hypertensive (HTN) patients. Comprehensive metagenomic and metabolomic analyses revealed decreased microbial richness and diversity, a Prevotella-dominated gut enterotype, and distinct metagenomic composition in pHTN and HTN groups. The microbiome characteristics of pHTN and HTN were similar, and host metabolism was closely linked to gut microbiota dysbiosis. A disease classifier based on microbiota and metabolites accurately distinguished pHTN and HTN individuals from controls. Fecal transplantation from hypertensive donors to germ-free mice resulted in elevated blood pressure, demonstrating the direct influence of gut microbiota on blood pressure. The study highlights the novel causal role of aberrant gut microbiota in hypertension pathogenesis and emphasizes the significance of early intervention for pHTN. The findings suggest that gut dysbiosis is a key factor in hypertension development, and that restoring gut microbiome homeostasis through diet, lifestyle changes, or early intervention with drugs or probiotics could help prevent hypertension and reduce cardiovascular risks. The study also shows that Prevotella, Klebsiella, Enterobacter, and Fusobacterium are potential candidates for further research on their role in hypertension. The results indicate that gut microbiota dysbiosis is closely linked to inflammatory states and that the overproduction of lipopolysaccharides by gut bacteria may directly contribute to hypertension development. The study underscores the importance of pHTN as a critical stage in hypertension progression and highlights the need for early intervention to prevent hypertension. The findings support the importance of controlling systolic blood pressure to an optimal level to reduce cardiovascular events and mortality. The study provides important evidence for the role of gut microbiota dysbiosis in hypertension and suggests that targeting gut microbiota could be a promising therapeutic approach for hypertension.Gut microbiota dysbiosis contributes to the development of hypertension. This study investigated the role of gut microbiota in hypertension by analyzing 196 participants, including 41 healthy controls, 56 pre-hypertensive (pHTN) individuals, and 99 hypertensive (HTN) patients. Comprehensive metagenomic and metabolomic analyses revealed decreased microbial richness and diversity, a Prevotella-dominated gut enterotype, and distinct metagenomic composition in pHTN and HTN groups. The microbiome characteristics of pHTN and HTN were similar, and host metabolism was closely linked to gut microbiota dysbiosis. A disease classifier based on microbiota and metabolites accurately distinguished pHTN and HTN individuals from controls. Fecal transplantation from hypertensive donors to germ-free mice resulted in elevated blood pressure, demonstrating the direct influence of gut microbiota on blood pressure. The study highlights the novel causal role of aberrant gut microbiota in hypertension pathogenesis and emphasizes the significance of early intervention for pHTN. The findings suggest that gut dysbiosis is a key factor in hypertension development, and that restoring gut microbiome homeostasis through diet, lifestyle changes, or early intervention with drugs or probiotics could help prevent hypertension and reduce cardiovascular risks. The study also shows that Prevotella, Klebsiella, Enterobacter, and Fusobacterium are potential candidates for further research on their role in hypertension. The results indicate that gut microbiota dysbiosis is closely linked to inflammatory states and that the overproduction of lipopolysaccharides by gut bacteria may directly contribute to hypertension development. The study underscores the importance of pHTN as a critical stage in hypertension progression and highlights the need for early intervention to prevent hypertension. The findings support the importance of controlling systolic blood pressure to an optimal level to reduce cardiovascular events and mortality. The study provides important evidence for the role of gut microbiota dysbiosis in hypertension and suggests that targeting gut microbiota could be a promising therapeutic approach for hypertension.