Bile acids and salt-sensitive hypertension: a role of the gut-liver axis

Salt-sensitivity of blood pressure (SSBP) affects 50% of the hypertensive and 25% of the normotensive populations. Importantly, SSBP is associated with increased risk for mortality in both populations independent of blood pressure. Despite its deleterious effects, the pathogenesis of SSBP is not ful...

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Published in:American journal of physiology. Heart and circulatory physiology 2022-04, Vol.322 (4), p.H636-H646
Main Authors: Ishimwe, Jeanne A, Dola, Thanvi, Ertuglu, Lale A, Kirabo, Annet
Format: Article
Language:English
Subjects:
Acids
Bile
Bile acids
Bile Acids and Salts
Blood pressure
Cardiovascular diseases
Cardiovascular system
Cell activation
Diet
Etiology
Gastrointestinal Microbiome - physiology
Homeostasis
Humans
Hypertension
Hypertension - chemically induced
Immune system
Intestinal microflora
Liver
Microbiomes
Pathogenesis
Populations
Pressure effects
Receptors
Review
Salts
Sodium
Sodium Chloride, Dietary - adverse effects
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Summary:Salt-sensitivity of blood pressure (SSBP) affects 50% of the hypertensive and 25% of the normotensive populations. Importantly, SSBP is associated with increased risk for mortality in both populations independent of blood pressure. Despite its deleterious effects, the pathogenesis of SSBP is not fully understood. Emerging evidence suggests a novel role of bile acids in salt-sensitive hypertension and that they may play a crucial role in regulating inflammation and fluid volume homeostasis. Mechanistic evidence implicates alterations in the gut microbiome, the epithelial sodium channel (ENaC), the farnesoid X receptor, and the G protein-coupled bile acid receptor TGR5 in bile acid-mediated effects on cardiovascular function. The mechanistic interplay between excess dietary sodium-induced alterations in the gut microbiome and immune cell activation, bile acid signaling, and whether such interplay may contribute to the etiology of SSBP is still yet to be defined. The main goal of this review is to discuss the potential role of bile acids in the pathogenesis of cardiovascular disease with a focus on salt-sensitive hypertension.
ISSN:0363-6135
1522-1539
DOI:10.1152/ajpheart.00027.2022