Targeting the Gut Heart Axis: Microbiota Based Strategies for Cardiovascular Disease Management

Abstract

The gut-heart axis represents a critical interface through which gut microbiota influences cardiovascular health and disease. Dysbiosis, characterized by microbial imbalance, contributes to cardiovascular diseases (CVDs) by promoting systemic inflammation and producing harmful metabolites like trimethylamine-N-oxide (TMAO), which accelerates atherosclerosis and endothelial dysfunction. Conversely, short-chain fatty acids (SCFAs), derived from microbial fermentation, exert anti-inflammatory and vasodilatory effects, mitigating CVD risk factors such as hypertension and cardiac fibrosis. Emerging therapies, including probiotics, prebiotics, and fecal microbiota transplantation (FMT), show promise in restoring microbial balance, improving lipid profiles, glycemic control, and blood pressure. However, challenges such as individual microbiome variability and the need for standardized clinical protocols hinder therapeutic translation. This review synthesizes mechanistic insights, clinical evidence, and therapeutic potential of targeting gut microbiota for CVD management, emphasizing the need for personalized approaches to address the global CVD burden.