Hypertension as a Metabolic Disorder and the Novel Role of the Gut.
Study Goal
The researchers aimed to explore the mechanisms by which high salt intake contributes to hypertension and metabolic disorders, focusing on the gut's role in blood pressure regulation.
Results Summary
High salt intake is linked to obesity and hypertension through mechanisms like heightened sympathetic nervous system activity, altered adipokine secretion, and gut microbiota changes. The gut plays a significant role in BP regulation via hormones like GLP-1 and ghrelin, sodium absorption pathways, and microbiota composition.
Population
General discussion, not specific to a defined population.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
high salt intake | increase | obesity | - | - | may tie to | #1 |
Heightened sympathetic nervous system (SNS) activity, especially in the kidney and brain | increase | blood pressure (BP) | obese patients | - | increases | #2 |
Adiponectin induced by a high-salt diet | decrease | sodium/glucose cotransporter (SGLT) 2 expression in the kidney | - | - | may decrease | #3 |
Adiponectin induced by a high-salt diet | decrease | BP | - | - | results in reducing | #4 |
High salt | neutral | secretions of adipokines and RAAS-related components | - | - | can change | #5 |
Glucagon-like peptide-1 (GLP-1) | decrease | BP | both rodents and humans | - | decrease | #6 |
ghrelin | decrease | BP | both rodents and humans | - | decrease | #7 |
The sweet taste receptor in enteroendocrine cells | increase | SGLT1 expression | - | - | increases | #8 |
The sweet taste receptor in enteroendocrine cells | increase | sodium/glucose absorption | - | - | stimulates | #9 |
Roux-en-Y gastric bypass | decrease | glycemic and BP control | - | - | improves | #10 |
Roux-en-Y gastric bypass | decrease | the activity of SGLT1 | - | - | due to reducing | #11 |
Na/H exchanger isoform 3 (NHE3) | increase | BP | - | - | increases | #12 |
Gastrin | decrease | NHE3 activity | - | - | inhibits | #13 |
Intestinal mineralocorticoid receptors | neutral | sodium absorption and BP | - | - | regulate | #14 |
Gastric distension | increase | BP | - | - | increases | #15 |
Changes in the composition and function of gut microbiota | increase | hypertension | - | - | contribute to | #16 |
A high-salt/fat diet | decrease | the gut barrier | - | - | may disrupt | #17 |
A high-salt/fat diet | increase | systemic inflammation, insulin resistance, and increased BP | - | - | results in | #18 |
Gut microbiota | neutral | BP | - | - | regulates | #19 |
probiotics | decrease | BP | - | - | BP-lowering effects of | #20 |
antibiotics | decrease | BP | - | - | BP-lowering effects of | #21 |
Bariatric surgery | decrease | metabolic disorders and hypertension | - | - | improves | #22 |
Bariatric surgery | increase | GLP-1 secretion | - | - | due to increasing | #23 |
Bariatric surgery | decrease | leptin secretion and SNS activity | - | - | due to decreasing | #24 |
Bariatric surgery | neutral | gut microbiome composition | - | - | due to changing | #25 |
PURPOSE OF REVIEW: Hypertension is related to impaired metabolic homeostasis and can be regarded as a metabolic disorder. This review presents possible mechanisms by which metabolic disorders increase blood pressure (BP) and discusses the importance of the gut as a novel modulator of BP. RECENT FINDINGS: Obesity and high salt intake are major risk factors for hypertension. There is a hypothesis of "salt-induced obesity"; i.e., high salt intake may tie to obesity. Heightened sympathetic nervous system (SNS) activity, especially in the kidney and brain, increases BP in obese patients. Adipokines, including adiponectin and leptin, and renin-angiotensin-aldosterone system (RAAS) contribute to hypertension. Adiponectin induced by a high-salt diet may decrease sodium/glucose cotransporter (SGLT) 2 expression in the kidney, which results in reducing BP. High salt can change secretions of adipokines and RAAS-related components. Evidence has been accumulating linking the gastrointestinal tract to BP. Glucagon-like peptide-1 (GLP-1) and ghrelin decrease BP in both rodents and humans. The sweet taste receptor in enteroendocrine cells increases SGLT1 expression and stimulates sodium/glucose absorption. Roux-en-Y gastric bypass improves glycemic and BP control due to reducing the activity of SGLT1. Na/H exchanger isoform 3 (NHE3) increases BP by stimulating the intestinal absorption of sodium. Gastrin functions as an intestinal sodium taste sensor and inhibits NHE3 activity. Intestinal mineralocorticoid receptors also regulate sodium absorption and BP due to changing ENaC activity. Gastric sensing of sodium induces natriuresis, and gastric distension increases BP. Changes in the composition and function of gut microbiota contribute to hypertension. A high-salt/fat diet may disrupt the gut barrier, which results in systemic inflammation, insulin resistance, and increased BP. Gut microbiota regulates BP by secreting vasoactive hormones and short-chain fatty acids. BP-lowering effects of probiotics and antibiotics have been reported. Bariatric surgery improves metabolic disorders and hypertension due to increasing GLP-1 secretion, decreasing leptin secretion and SNS activity, and changing gut microbiome composition. Strategies targeting the gastrointestinal system may be therapeutic options for improving metabolic abnormalities and reducing BP in humans. SNS, brain, adipocytes, RAAS, the kidney, the gastrointestinal tract, and microbiota play important roles in regulating BP. Most notably, the gut could be a novel target for treatment of hypertension as a metabolic disorder.