The Gut Microbiome, Inflammation, and Salt-Sensitive Hypertension

Abstract

Purpose of Review Salt sensitivity of blood pressure (SSBP) is an independent predictor of death due to cardiovascular events and affects nearly 50% of the hypertensive and 25% of the normotensive population. Strong evidence indicates that reducing sodium (Na+) intake decreases blood pressure (BP) and cardiovascular events. The precise mechanisms of how dietary Na+ contributes to elevation and cardiovascular disease remain unclear. The goal of this review is to discuss mechanisms of salt-induced cardiovascular disease and how the microbiome may play a role. Recent Findings The innate and adaptive immune systems are involved in the genesis of salt-induced hypertension. Mice fed a high-salt diet exhibit increased inflammation with a marked increase in dendritic cell (DC) production of interleukin (IL)-6 and formation of isolevuglandins (IsoLG)-protein adducts, which drive interferon-gamma (IFN-γ) and IL-17A production by T cells. While prior studies have mainly focused on the brain, kidney, and vasculature as playing a role in salt-induced hypertension, the gut is the first and largest location for Na+ absorption. Research from our group and others strongly suggests that the gut microbiome contributes to salt-induced inflammation and hypertension. Summary Recent studies suggest that alterations in the gut microbiome contribute to salt-induced hypertension. However, the contribution of the microbiome to SSBP and its underlying mechanisms are not known. Targeting the microbiota and the associated immune cell activation could conceivably provide the much-needed therapy for SSBP.

Hypertension as Three Systematic Dysregulations of Na+ Homeostasis in Terrestrial Mammal, and Salt in Gut Might Cause Brain Inflammation

“…As mentioned earlier in this chapter, excessive salt in the intestine is assumed to be trigger of onset of hypertension via dysbiosis of the gut microbiome (GM) [52]. In an animal study, it was reported that a decrease in lactobacillus murinus caused by salt intake altered the intestinal microbiome and contributed to the development of hypertension [53].…”

Nutrition and the Covid-19 pandemic: Three factors with high impact on community health

“…A different but related issue is the effect of excess dietary salt consumption on the intestinal microbiota, which has been recognized as an integral part of our immune system [42]. It was reported that a salt load in healthy volunteers reduced the abundance of various Lactobacillus species in faecal samples, and this was associated with a rise in the concentration of proinflammatory TH17 cells in the blood [43].…”

Gut Dysbiosis and Western Diet in the Pathogenesis of Essential Arterial Hypertension: A Narrative Review

“…AH is a potent modifiable cardiovascular (CV) risk factor and is the leading cause of mortality related to chronic kidney failure, ischemic heart disease and stroke [ 3 , 4 , 5 , 6 ]. According to ATP III criteria, MetS is characterized by at least three of the following five parameters: glycemia >100 mg/dL or glucose-lowering therapy, high-density lipoprotein- cholesterol (HDL-C) <40 mg/dL (men) or HDL-C <50 mg/dL (women) or lipid-lowering therapy, triglycerides (TG) >150 mg/dL, waist circumference (WC) >102 cm (men) or >88 cm (women), BP > 130/85 mmHg or anti-hypertensive therapy [ 7 ].…”

“…High salt intake is a well-known risk factor for AH and CV diseases [ 17 , 32 ]. At gut level, sodium interacts with commensal microbiota and can lead to AH, as recently explored by several authors [ 4 , 33 , 34 ].…”