Microbiome-Based Therapeutics for Salt-Sensitive Hypertension: A Scoping Review

Area of Science:

• Microbiome research
• Cardiovascular health
• Metabolic disorders

Background:

• Salt-sensitive hypertension affects a significant portion of the hypertensive population.
• The gut microbiome's role in metabolic and cardiovascular health is increasingly recognized.
• Short-chain fatty acids (SCFAs) produced by gut bacteria are bioactive metabolites with potential health implications.

Purpose of the Study:

• To conduct a comprehensive scoping review of current knowledge on the gut microbiome and SCFAs for salt-sensitive hypertension.
• To identify and synthesize findings from human and animal studies on microbiome-based interventions.
• To highlight existing knowledge gaps and future research directions.

Main Methods:

• Systematic literature search of PubMed for studies published up to August 2024.
• Inclusion of 24 trials: 9 human (6 observational, 3 interventional) and 15 animal (all interventional).
• Categorization of interventions including dietary changes, prebiotic, probiotic, and postbiotic/live biotherapeutic products.

Main Results:

• Human studies primarily focused on comparing microbiota between hypertensive and normotensive individuals.
• Human interventions included sodium-restricted diets and prebiotic supplementation.
• All animal interventions (dietary, probiotic, postbiotic, live biotherapeutics) demonstrated effectiveness in reducing blood pressure.

Conclusions:

• Microbiome-based therapies represent an emerging biologic approach for managing salt-sensitive hypertension.
• Interventions targeting the gut microbiome and its metabolites show consistent blood pressure-lowering effects.
• Significant knowledge gaps persist, necessitating further research to optimize these novel therapeutic strategies.