The Gastrointestinal Tract: an Initial Organ of Metabolic Hypertension?
The Gastrointestinal Tract: an Initial Organ of Metabolic Hypertension?
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DOI：
10.1159/000443107
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发表时间：
2016-05
影响因子：
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通讯作者：
Zhiming Zhu;Shiqiang Xiong;Daoyan Liu
中科院分区：
文献类型：
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作者：
Zhiming Zhu;Shiqiang Xiong;Daoyan Liu
高血压是一个重要的全球公共卫生挑战，因为它的高患病率和伴随的心血管和肾脏疾病的风险。超过60%的高血压危险因素与代谢紊乱有关。此外，许多代谢危险因素可直接导致血管功能障碍和血压升高。代谢紊乱不仅增加高血压的风险，而且参与高血压的发展。因此，代谢紊乱引起的某些类型的高血压可被定义为代谢性高血压。然而，代谢性高血压的发病机制仍然在很大程度上是未知的。胃肠道是一个独特的大门，外部食物，代谢物和微生物通过它进入人体。因此，代谢相关风险因素可能通过胃肠道影响血压，并改变味觉、粘膜吸收、肠道激素稳态、GI神经活动和肠道微生物群等过程。同时，通过饮食、肠道菌群改造和代谢手术等途径进行胃肠道干预，可以显著改善或缓解血管功能障碍和代谢性高血压。提示胃肠道可能是代谢性高血压的起始器官。然而，需要更多的临床和基础研究来进一步验证这一新概念。
Hypertension is an important global public-health challenge because of its high prevalence and concomitant risks for cardiovascular and kidney diseases. More than 60% of the risk factors for hypertension are associated with metabolic disorders. Furthermore, many metabolic risk factors can directly cause the vascular dysfunction and the elevated blood pressure. Metabolic disorders not only increase the risk for hypertension but also participate in the development of hypertension. Thus, some types of hypertension induced by metabolic disturbances can be defined as metabolic hypertension. However, the pathogenesis of metabolic hypertension remains largely unknown. The gastrointestinal tract is a unique gate through which external food, metabolites, and microbes enter the human body. Thus, metabolism-related risk factors may affect blood pressure through the gastrointestinal tract and alter processes such as taste perception, mucosal absorption, gut hormone homeostasis, GI nerve activity, and gut microbiota. Meanwhile, gastrointestinal intervention through dietary approaches, gut microbiota modification, and metabolic surgery could profoundly improve or remit the vascular dysfunction and metabolic hypertension. It suggests that the GI tract could be an initial organ of metabolic hypertension. However, more clinical and basic studies are necessary to further validate this novel concept.