New link between the gut and hypertension revealed

A new study from Monash University has added to GPs’ current understanding of the links between gut health and hypertension (HT).
 
The study has identified that two intestinal cell receptors (GPR41 and GPR43) play a key role in creating this link, with early findings showing that when activated by dietary fibre, these receptors trigger anti-inflammatory mechanisms.
 
While in the absence of adequate dietary fibre, gut cells can become leaky and lead to generalised inflammation.
 
Lead author Dr Rikeish Muralitharan said the findings suggest systemic inflammation, which is implicated in many disease processes, may originate in the gut.
 
‘We demonstrate that GPR41 and 43 are, at least partially, responsible for the blood pressure-lowering and cardio-protective effects of a high fibre diet,’ he said.
 
‘Our study shows that the lack of activation of the receptors, copying a situation when we don’t have enough fibre in our diet, leads to increased gut permeability, allowing microbial components into the circulation.
 
‘This activates inflammation in key organs such as the kidney, which regulate blood pressure, and which leads to hypertension.’
 
According to researchers, these findings could pave the way for the development of new pharmaceutical therapies to broaden GPs’ therapeutic repertoire for HT.

They said trials for new medications utilising this research are already underway.
 
While early detection and lifestyle modification remain the mainstay of management for high blood pressure, prescription medications also play a crucial role.
 
RACGP Specific Interests Obesity Management Chair Dr Terri-Lynne South said GPs are sometimes ‘faced with a dichotomy about medication interventions and non-medication interventions, and this research supports mobilising both together.
 
‘I look at this research and think “excellent we’ve got to do both right now”,’ she told newsGP.
 
‘I’m excited on two levels. One is, there’s a suggestion that there might be a mechanism for which we can have future therapeutic medications to help hypertension.
 
‘But I also am excited to see that it’s reinforcing a connection about the role of non-medication interventions, which is improvement of dietary fibre intake, not just for gut health, but specifically for hypertension.’
 
With one in three Australians having high blood pressure, and with it remaining undiagnosed or undertreated in many patients, HT remains a leading cause of heart attacks, strokes and kidney disease.
 
Dietary fibre is known to decrease HT and is particularly found in plant-based foods, including fruit and vegetables, whole grain foods and nuts, seeds and legumes.
 
Associate Professor Ralph Audehm from the University of Melbourne’s Department of General Practice told newsGP the research ‘vindicates all the things we’ve known to date – that eating healthily is good for you’.
 
‘[The researchers] have been able to break it down to the smallest components, but life’s not like that … at the end of the day, it’s probably the totality of all the things that we eat combined that are actually giving us the benefit,’ he said.
 
‘We have known for centuries that a good healthy diet improves many things. We know it’s good for heart disease and hypertension, for diabetes, for depression. It just keeps on giving.
 
‘As clinicians the main change for us is to re-enforce the lifestyle aspect of healthcare and support our patients to pay much more attention to this aspect.’
 
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