Beyond the Microbiome: The Gut's Role in Hypertension

This review emphasizes the importance of investigating the gut itself-beyond microbiota-centered studies in the context of hypertension. Since the initial discovery of the connection between gut microbiota and blood pressure regulation, research has increasingly focused on understanding the role of gut microbiota and exploring strategies to modify it for better blood pressure management. The intestine as an organ has received comparatively less attention. Yet, hypertension-associated intestinal pathological changes are well documented in both rodent models and human patients. Research to restore the intestinal function may serve as a valuable but unexplored therapeutic target. This underscores the need for a summary of our understanding of the gut's intrinsic physiological and pathological roles in hypertension. To address this, we structured our review to (1) revisit the physiological functions of the intestine; (2) describe the pathological changes that are associated with hypertension; (3) summarize available current studies targeting to restore intestinal function for blood pressure control; and (4) discuss knowledge gaps and future opportunities.