A influência da microbiota intestinal na etiopatogenia da hipertensão arterial sistêmica.

Abstract

The pathogenesis of hypertension involves genetic and environmental factors; and research indicates that intestinal dysbiosis may be associated with the etiopathogenesis of hypertension. In this sense, the objective was to conduct an integrative review on the influence of the intestinal microbiota on the etiopathogenesis of arterial hypertension (AH). A search was performed in the databases: Google Scholar, PubMed, Scielo and Lilacs, using the descriptors: microbiota, blood pressure and arterial hypertension. Fourteen articles from the last 9 years that pointed out the influence of the intestinal microbiota on the etiopathogenesis of arterial hypertension were analyzed. AH has been associated with intestinal dysbiosis, either due to the lower diversity of microorganisms and/or the predominance of certain genera; associated with a reduction in acetate and butyrate-producing bacteria and an increase in lactate-producing bacteria. Hypertensive individuals tend to have increased intestinal permeability, which can be restored after modulation of the microbiome with fecal microbiota transplantation. High-salt diets appear to promote changes in the proportion of Firmicutes/Bacteroides in the intestine, leading to increased TMAO. TMAO is a result of the ingestion of foods rich in TMA, present in animal products, contributing to vasoconstriction and stimulating the production of reactive oxygen species, which result in vascular lesions. Strategies regarding intestinal modulation through microorganisms that induce BP control, supplementation with SCFA and reduction of dietary salt can be used as ways to treat hypertension.