The Role of Gut Microbiota in Hypertension Management - A Review
DOI:
https://doi.org/10.12775/QS.2025.38.57655Keywords
hypertension, gut microbiota, short chain fatty acids, fecal microbiota transplantation, probiotics, trimethylamine-N-oxide, TMAO, physical activity, dietary interventionsAbstract
Introduction and purpose: Hypertension, or high blood pressure, is a condition characterized by persistently elevated
arterial pressure, leading to severe complications such as heart disease, stroke, and kidney
failure. According to the World Health Organization (WHO), hypertension affects
approximately 1.13 billion people worldwide, contributing significantly to global morbidity
and mortality. Emerging research has revealed a significant connection between gut
microbiota—the diverse community of microorganisms residing in the gastrointestinal
tract—and the regulation of blood pressure. This comprehensive review explores the intricate
relationship between gut microbiota and hypertension, delving into the underlying
mechanisms, evidence from animal and human studies, and potential therapeutic
interventions.
The state of knowledge: Key mechanisms involved into regulation of blood pressure include the production of short-
chain fatty acids (SCFAs), modulation of the renin-angiotensin system (RAS), immune system regulation, and metabolite production such as trimethylamine-N-oxide (TMAO). Animal studies using fecal microbiota transplantation (FMT) have provided strong evidence
for a causal role of gut microbiota in blood pressure regulation. Human studies have shown
associations between gut microbiota composition and hypertension, highlighting the potential
for dietary interventions, probiotics, prebiotics, physical activity and FMT as therapeutic
strategies.
Summary: This review underscores the promise of microbiota-targeted therapies in managing
hypertension and calls for further research to elucidate precise mechanisms and develop
personalized medicine approaches. Understanding the complex interactions between gut
microbiota and hypertension could pave the way for innovative treatments and improved
cardiovascular health outcomes.
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