Abstract Body: Introduction: New research shows that the group of microbes in the intestine can influence blood pressure. Researchers believe that gut microbes may partly influence blood pressure through molecules called metabolites and by causing inflammation. We gathered and analyzed data to link the gut microbiota with blood pressure and to understand the outcome of efforts to treat hypertension using microbiome targets.
Hypothesis: Activating G-protein-coupled receptors (GPR41/43) in renal epithelial cells, butyrate stimulates sodium excretion and modulates the activity of endothelial nitric oxide synthase (eNOS) by affecting its histone deacetylase activity (HDAC).
Methods: Using a PRISMA method, we researched people in whom gut microbiota or probiotic effects were measured for blood pressure. The approach found sixteen studies, and fifteen were included after using the chosen criteria (6 randomized controlled trials and 9 observational studies). We looked at the gut microbiome of hypertensive and normotensive people and tracked how probiotic supplements or a certain diet changed blood pressure. To check the quality of the studies, researchers applied the Cochrane Risk of Bias for RCTs and the Newcastle-Ottawa Scale.
Results: The gut microbiome of people with hypertension remained much lower in diversity and reduced in some health-promoting genera, especially Lactobacillus and Bifidobacterium. Researchers discovered that high amounts of microbiome-related metabolites in the body are linked to raised blood pressure, suggesting these play a role in hypertension. Probiotics or higher fiber intake in RCTs helped decrease blood pressure. The individual outcomes differed, but overall, treating the microbiome with probiotics reduced both blood pressure and markers of inflammation. Even though most research was moderate in strength, it kept showing that the gut plays a role in managing blood pressure.
Conclusions: The review gathers existing information on the relationship between gut microbiota and hypertension. We have found that blood pressure is related to gut bacteria and that small improvements in blood pressure may result from changing the gut microbiome (with probiotics or by diet). Even so, this new knowledge suggests that manipulating gut microbes could be used to treat hypertension. However, further and longer-lasting research is necessary to determine causality and how best to approach treatment strategy.