High blood pressure and the dependence of coronary heart disease on the gastrointestinal system

Coronary heart disease (CHD) and arterial hypertension have long been regarded as diseases linked to lifestyle, metabolic disorders and genetic factors. In recent years, however, a growing body of scientific evidence has pointed to the important role of the gastrointestinal system (GIS) in the development and progression of cardiovascular disease. This review examines the connection between the state of the GIS, blood pressure and CHD.

The gastrointestinal tract as a key player in the regulation of vascular tone

Modern research shows that the intestine plays not only a digestive but also a metabolic, immune and neurohumoral role. Through the regulation of the microbiota, the synthesis of hormones and its influence on the autonomic nervous system, the gastrointestinal tract can directly affect vascular tone and the level of blood pressure.

The main mechanisms by which the GI tract affects blood pressure:

• Dysbacteriosis. An imbalance of the microflora can lead to systemic inflammation, endothelial dysfunction and the development of hypertension.

• Endotoxins. When the permeability of the intestinal wall increases, bacterial toxins (lipopolysaccharides) enter the bloodstream, activating the immune system and raising vascular resistance.

• Disturbed sodium metabolism. The GI tract regulates the reabsorption and transport of sodium, which directly affects the volume of circulating blood and blood pressure.

CHD and the gastrointestinal system: a hidden connection

Although CHD is usually considered a consequence of atherosclerosis of the coronary arteries, the role of the GI tract in this process cannot be ignored. The interaction between the intestine and the heart is often called the “gut–heart axis” (gut-heart axis).

The connecting links:

• Low-grade inflammation — chronic inflammation sustained by disturbances in the intestinal microflora accelerates the progression of atherosclerosis.

• Lipid metabolism disorders — the microbiota affects the metabolism of cholesterol and triglycerides, determining the risk of plaque formation in the arteries.

• Trimethylamine N-oxide (TMAO) — a metabolite produced by intestinal bacteria that raises the risk of thrombosis and coronary events.

Rising blood pressure: a consequence or a cause of GI disorders?

Numerous clinical observations confirm that patients with arterial hypertension often complain of constipation, bloating, gastritis and disorders of bile secretion. This may be more than a coincidence.

Some hypertension medicines (for example, calcium channel blockers) cause constipation, but the influence also works in the opposite direction: slowed peristalsis increases intoxication of the body, raises the level of stress hormones and, as a result, blood pressure.

How improving the GI tract affects the cardiovascular system

Modifying the microflora, normalising the work of the GI tract and eliminating digestive disorders can serve as effective prevention of hypertension and CHD. Some approaches:

• Probiotics and prebiotics — normalise the microbiota and reduce inflammation.

• A diet high in fibre — supports intestinal health and helps lower cholesterol levels.

• Limiting sugar and saturated fats — prevents dysbiosis and the increased formation of TMAO.

• Regular cleansing of the body — gentle physiotherapy methods or sanatorium treatment help lower toxin levels and normalise blood pressure.

Conclusion

High blood pressure and coronary heart disease are inseparably linked to the state of the gastrointestinal system. Modern medicine increasingly regards the GI tract as an important control point for systemic health. A comprehensive approach to diagnosis and treatment — one that necessarily takes intestinal function into account — can significantly increase the effectiveness of the prevention and therapy of cardiovascular disease.