Effects of probiotics on hypertension

Emerging data have suggested that probiotics had good potential in regulating intestinal flora and preventing hypertension. Some studies in human and animal models have demonstrated probiotic intervention could attenuate hypertension, regulate intestinal flora to increase the abundance of beneficial bacteria, and regulate intestinal microbial metabolites such as trimethylamine oxide, short-chain fatty acids, and polyphenols. However, there is still some debate as to whether probiotics exert effective benefits. These recently published reviews did not systematically expound on the heterogeneity between the effect and mechanism of probiotics with different types, doses, and carriers to exert antihypertensive effects, as well as the possible application of probiotics in the prevention and treatment of hypertension in food and clinic. Here we try to systematically review the association between hypertension and intestinal microflora, the effect of probiotics and their metabolites on hypertension, and the recent research progress on the specific mechanism of probiotics on hypertension. In addition, we also summarized the potential application of probiotics in antihypertension. Future challenges include elucidating the functions of metabolites produced by microorganisms and their downstream pathway or molecules, identifying specific strains, not just microbial communities, and developing therapeutic interventions that target hypertension by modulation of gut microbes and metabolites.