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Hypertension as a Metabolic Disorder and the Novel Role of the Gut.

Current hypertension reports
January 1, 1970
Masami Tanaka et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

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

Extracted Claims (25)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
Bariatric SurgeryBlood PressureGastrointestinal MicrobiomeHumansHypertensionObesity
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations70
Citations/Year11.7
Relative Citation Ratio3.86
NIH Percentile89.6%
Research Impact Scores
APT Score0.75
Weight Score1.90
Normalized Score0.62
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