High blood pressure is known as one of the most common chronic conditions among the elderly. Called the “silent killer” due to its inconspicuous early symptoms, it poses a severe threat to the elderly’s health. Long-term hypertension may trigger severe consequences like stroke, myocardial infarction, and heart failure, potentially shortening lifespan.
Recent studies shows that gut microbiota and its metabolites play a significant role in the pathogenesis of hypertension.
So, what factors within the gut microbiota will affect on our blood pressure?
Prof. Dai Wenxin, Director of the Geriatric Multidisciplinary Diagnosis and Treatment Center at Hainan Chengmei Hospital and an expert in gut microbiota therapy, stated that the gut is often hailed as the bodys “second brain,” because its microecological balance is closely linked to blood pressure regulation. Within the gut, over 100 trillion microorganisms form a complex ecosystem, within which blood pressure will be positively influenced by regulating this micro-ecosystem, restoring microbiota diversity, and optimizing metabolic secretions.
The Vagus Nerve - A “Communication Highway” inside Human Body: Microbes in the gut and the metabolites they produces will “inform” the brain through the vagus nerve toregulate blood pressure. Studies found that administering butyrate (a gut microbial metabolite) into the rectum will significantly lower blood pressure. However, if the vagus nerve below the diaphragm is severed, this blood pressure-lowering effect is substantially diminished.
The Marvelous Assistant for Metabolism: Gut microbiota produces numerous things, among which butyrate of short-chain fatty acid is particularly remarkable. It can activate two receptors in the gut, GPR41 and GPR43, like a key code. This mechanism dilates mesenteric blood vessels, and will lower blood pressure.
The Gut’s “Guardians of the Walls”: When gut microbiota becomes imbalanced, it generates excessive harmful stuff, such as reactive oxygen species, which will trigger inflammation and damage DNA in cells. This inflammatory response will breach intestinal barrier, known as the gut’s “defensive walls”, allowing toxins to infiltrate the bloodstream and ultimately elevate blood pressure.
The “Malfunction” of the Immune System: Inflammatory cytokines produced by gut inflammation will cause “trouble”to vascular endothelial cells and kidneys. Under this circumstance, blood vessels will fail to maintain their normal contractile function, and the renin-angiotensin-aldosterone system (RAAS) is mistakenly activated, which will lead to uncontrolled blood pressure spikes.
Thus, maintaining gut microbiota diversity and balance through healthy diet and lifestyle is crucial for preventing and managing hypertension.
The “Gut-Brain Axis”: The “Information Superhighway” Linking Gut and Blood Pressure
Prof. Dai Wenxin explains that the "gut-brain axis" is a complex regulatory network comprising the central nervous, neuroendocrine, and immune systems.
Neural Regulation: Dysbacteriosis in gut willdisrupt neurotransmitter secretion, including serotonin, GABA, directly impacting on sympathetic nervous activity. Clinical studies revealed significantly reduced serotonin-producing bacteria in hypertensive patients with depression and hypertension.
Metabolic Regulation: The microbial metabolite trimethylamine N-oxide (TMAO) elevates blood pressure by 10-15 mmHg via vascular smooth muscle cell calcification, while short-chain fatty acids lower blood pressure by activating PPAR-γ pathways.
Immune Regulation: Systemic inflammation from gut dysbiosis impairs vascular endothelial function. A cohort study of 1,200 subjects showed each 1mg/L increase in C-reactive protein correlates with a 17% higher hypertension risk.
Then how does gut microbiota regulate blood pressure?
Professor Dai Wenxin emphasized that beneficial bacteria can modulate the structure of gut microbiota, reduce pathogenic bacteria, and enhance the function of intestinal barrier. Hence Fecal Microbiota Transplantation (FMT) is an effective therapeutic approach for hypertensive patients. FMT-mediated colonization of beneficial bacteria will improve gut microbial balance, directly influences microbiota composition and metabolism, and participates in blood pressure regulation. Additionally, probiotic supplementation will activate the immune system and controls inflammation, while FMT further regulates blood pressure by controllingblood lipid level and so on.
As microecological research advances, FMT offers new hope for geriatric hypertension management, bringing not only a breakthrough for gastrointestinal disorders but also new intervention treatments in chronic diseases.
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