Role of Gut Microbes in Hypertension: A Systematic Review of Literature

Abstract

Objectives: Hypertension is a metabolic disorder affecting a significant proportion of the global population. Growing evidence suggests the contribution of gut microbiota to blood pressure homeostasis and the effectiveness of antihypertensive interventions. This systematic review evaluates the role of gut microbiota in hypertension and identifies microbial taxa contributing to or alleviating the condition.

Methods: A systematic search was conducted in PubMed and Cochrane databases for non-randomized studies, randomized controlled trials, and registry studies published in English. Studies were classified according to microbial taxa involved in the improvement or worsening of hypertension.

Results: According to the inclusion criteria, 19 studies were included. Some bacterial genera, such as Lactobacillus paracasei, Akkermansia, and Veillonella, had potential protective effects against hypertension by regulating blood pressure through dietary interactions and microbial metabolites. On the other hand, Klebsiella sp., Streptococcus sp., and Parabacteroides merdae were more abundant in hypertensive patients and were involved in dysbiosis and inflammation. The fungal taxa Malassezia and Mortierella were also involved in the pathogenesis of hypertension.

Conclusions: Gut microbiota composition may play crucial roles in hypertension, with certain taxa potentially contributing to or alleviating the condition. Modulating gut microbes through probiotics and diet may offer new therapeutic approaches.

Keywords: blood pressure; cardiovascular disease; dysbiosis; endothelial function; gut barrier; gut microbiota; hypertension; microbial interventions; probiotics.

Fig. 1. PRISMA flow diagram of systematic review methodology. PRISMA: Preferred Reporting Items for Systematic reviews and Meta-Analyses