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. Author manuscript; available in PMC: 2023 Feb 4.
Published in final edited form as: Circ Res. 2022 Feb 3;130(3):401–417. doi: 10.1161/CIRCRESAHA.121.319816

Figure 1. Bidirectional gut-brain axis in hypertension.

Figure 1.

HTN stimuli influence both autonomic brain regions and the gut in the regulation of BP. They stimulate brain endocrine, neural and immune system associated pathways which converge on to the gut to regulate secretion of gut hormones, microbial communities, metabolites and gut immune status. These culminate in impaired epithelial-microbiota communication in HTN. Furthermore, HTN-associated dysbiosis-linked altered gut metabolites are released into the blood through leaky gut, access the brain through leaky BBB, and influence neuronal-microglial communication increasing neuroinflammation. HTN stimuli can also influence the gut directly to initiate alteration in epithelial-microbiota interactions. Illustration Credit: Ben Smith.