Endothelial Dysfunction and Hypertension in African Americans: Overview of the Role of the Gut Microbiome

Abstract

Hypertension (now defined by systolic blood pressure/diastolic blood pressure [SBP/DBP] greater than 130/90 mmHg), is one of the most common cardiovascular disorders and is a critical public health and economic concern. African Americans have the greatest burden of hypertension and elucidating the causes of this racial disparity is important for amending and developing effective treatment strategies. Although studies have provided mechanistic insight concerning characteristics of endothelial dysfunction, which likely precedes hypertension in African Americans, our knowledge is limited concerning internal systems (i.e., gut) that may affect endothelial and vascular health outcomes. Recent studies report that the types, and balance, of microbes in the gut are significant contributors to health and disease. Gut microbial dysbiosis, an unhealthy and poorly diverse gut microbial profile, has been linked to hypertension and other diseases that may disproportionately affect cardiovascular health. Relative to hypertension, dysbiosis has been characterized as a reduced richness of short chain fatty acid (SCFA) producing microbes. SCFAs are significant metabolites produced by gut microbes beneficially impact cellular functions, specifically vascular smooth muscle and endothelial cells. Studies concerning the gut microbiome and cardiovascular disease are limited in humans and grossly underrepresent minority populations. This brief review will overview factors concerning the racial disparity in hypertension and provide insight into the potential role that gut dysbiosis may have in hypertension, highlighting the “gut-vascular axis” concerning cardiovascular health.