Emerging evidence suggests that gut microbiota play an essential role in the pathogenesis of obesity-related hypertension. The gut microbiome influences metabolic processes and systemic inflammation, both of which are critically linked to blood pressure regulation. Dysbiosis, or an imbalance in gut microbiota composition, can exacerbate obesity and its related metabolic disorders (Cheungpasitporn et al., 2025).

In a recent study involving CBS, it was shown that CBS treatment improved gut microbial diversity in obese rats, which was associated with significant reductions in both blood pressure and body weight. The restoration of intestinal homeostasis was linked to increased production of IL-22, a cytokine known for its protective effects on the intestinal barrier and its role in regulating immune responses (Shu et al., 2025). Furthermore, the modulation of gut microbiota through CBS may provide a therapeutic avenue for enhancing metabolic health and reducing hypertension.

Table 2: Gut Microbiota and Hypertension

Microbiota Type	Role in Hypertension
Firmicutes	Increased absorption of energy
Bacteroidetes	Associated with lower obesity rates
Proteobacteria	Linked to increased inflammation

Interleukin-22: A Key Player in Gut Health and Hypertension

Interleukin-22 (IL-22) is a cytokine produced by ILC3s in the gut, playing a critical role in maintaining gut barrier integrity and modulating inflammation. In obesity-related hypertension, IL-22 has been shown to counteract the adverse effects of pro-inflammatory cytokines and support the repair of the intestinal epithelial barrier (Shu et al., 2025).

Studies have indicated that CBS enhances IL-22 production in the intestines of obese rats, which subsequently improves gut health and reduces systemic inflammation, contributing to lower blood pressure. This highlights the importance of IL-22 as a therapeutic target in managing obesity and its cardiovascular complications.

Table 3: Role of IL-22 in Hypertension Management

Mechanism	Effect on Hypertension
Enhances intestinal barrier	Reduces endotoxin translocation
Modulates immune response	Decreases systemic inflammation
Promotes gut health	Improves metabolic profiles

The current landscape of managing obesity-related hypertension is evolving, with innovative strategies emerging to bridge the gap in treatment efficacy. CBS represents one such approach, combining neuromodulation with potential metabolic benefits. Other promising interventions include lifestyle modifications, dietary interventions, and the use of gut-targeted therapies.

Additionally, ongoing research into the role of gut microbiota and inflammation in hypertension may yield new therapeutic targets, providing a more holistic approach to managing obesity and its cardiovascular implications (Zhang et al., 2025). As our understanding of these complex interactions deepens, personalized medicine approaches that consider individual metabolic profiles and gut health may enhance treatment outcomes for patients facing obesity-related hypertension.

Table 4: Innovative Interventions for Hypertension

Intervention	Description
Carotid Baroreceptor Stimulation	Modulates SNS activity, lowers BP
Dietary Modifications	Promotes gut health and reduces obesity
Gut Microbiota Modulation	Targets dysbiosis linked to hypertension

FAQ

What is carotid baroreceptor stimulation? Carotid baroreceptor stimulation is a technique that modulates the neural activity of the sympathetic nervous system to lower blood pressure and improve metabolic health.

How does obesity affect hypertension? Obesity can lead to increased sympathetic nervous system activity, resulting in higher blood pressure and a greater risk of cardiovascular diseases.

What role does gut microbiota play in hypertension? Gut microbiota influences metabolic processes and inflammation, which can exacerbate hypertension. Dysbiosis is linked to increased blood pressure and obesity.

What is the significance of interleukin-22? IL-22 is a cytokine that helps maintain gut health and integrity, and its increased production can improve conditions associated with obesity and hypertension.

What innovative methods are being explored for managing obesity-related hypertension? Current strategies include carotid baroreceptor stimulation, dietary changes, and therapies aimed at modulating gut microbiota to enhance metabolic health.

References

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Mancia, G., Kreutz, R., Brunström, M., et al. (2023). 2023 ESH Guidelines for the management of arterial hypertension. J Hypertens
Mills, K. T., Bundy, J. D., Kelly, T. N., et al. (2021). Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation
Cheungpasitporn, W., et al. (2025). Research trends and performance of endothelin A receptor antagonist in kidney care: a bibliometric analysis. Ren Fail. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11995767/
Shu, Y., et al. (2025). Carotid baroreceptor stimulation attenuates obesity-related hypertension through sympathetic-driven IL-22 restoration of intestinal homeostasis. Eur J Med Res. Retrieved from https://doi.org/10.1186/s40001-025-02528-0
Zhang, J., et al. (2025). Adipocyte-derived shed Syndecan-4 suppresses lipolysis contributing to impaired adipose tissue browning and adaptive thermogenesis. Mol Metab. Retrieved from https://doi.org/10.1016/j.molmet.2025.102133
Sande, I. S., et al. (2025). Follow-Up in Primary Care After Ischemic Stroke – Insights From the Nor-COAST Study. Int J Gen Med. Retrieved from https://doi.org/10.2147/IJGM.S508154