Hypertension is increasing worldwide and has reached epidemic proportions, largely due to modern lifestyle factors. Sedentary work, obesity, lack of physical activity, chronic stress, consumption of junk and fatty foods, excessive caffeine intake, alcohol use, smoking, and inadequate sleep are major contributors.
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Mental stress is one of the most significant culprits. In addition, frequent use of certain over-the-counter cold medications and prolonged or excessive steroid use may also contribute to the development of hypertension. The condition often runs in families, passing from one generation to the next.
Persistent high blood pressure is well known to damage vital organs such as the eyes, nervous system, kidneys, heart, and reproductive system. It also affects the digestive system adversely, affecting digestion and overall nutrition of the body.
High blood pressure causes multiple adverse changes in the digestive system, impairing digestion and the absorption of nutrients from the gut. Over time, these changes insidiously contribute to systemic complications in the body.
Hypertension significantly affects the digestive system by disrupting the normal microbial flora of the gut, leading to damage of the intestinal lining. This results in reduced microbial diversity, with a decrease in beneficial bacteria and an increase in potentially harmful organisms. Consequently, susceptibility to indigestion and gastrointestinal infections increases. Gut dysbiosis is also a recognized risk factor for the development of type 2 diabetes mellitus. In addition, mental health may be adversely affected, manifesting as increased stress, anxiety, low mood, and sleep disturbances. Reduced energy levels and easy fatigability are also commonly experienced.
Hypertension can also lead to fibrosis and chronic inflammation of the gut, resulting in symptoms such as bloating, belching, abdominal pain, constipation, and/or diarrhoea. Persistent gut inflammation causes the release of inflammatory mediators into the bloodstream, which may stimulate the sympathetic nervous system. This disrupts effective blood pressure control, leading to further elevation of blood pressure. As a result, the risk of cardiac arrhythmias and other cardiovascular complications increases.
These inflammatory changes may also manifest as skin conditions such as acne and eczema and can aggravate autoimmune disorders, including rheumatoid arthritis and systemic lupus erythematosus (SLE). Associated symptoms may include headaches, joint pain, and cognitive difficulties such as brain fog. Food sensitivities may develop, presenting as allergic skin reactions, worsening of asthma, or allergic rhinitis and cough. These reactions can range from mild and trivial to severe and potentially life-threatening. Mood disturbances are also common, with individuals experiencing low mood, loss of interest in daily activities, and easy fatigability.
Fibrosis leads to thickening of the gut wall, resulting in shortening of the intestinal villi—the structures responsible for nutrient absorption. This impairs the absorption of essential nutrients from the gut and, over time, may lead to poor nutritional status and malnutrition. Deficiency of vital nutrients adversely affects overall health and bodily functions.
The gut also plays a crucial role in maintaining sodium and electrolyte balance in the body. Disturbance of this function can result in symptoms such as diarrhoea, abdominal bloating, and dehydration, occurring singly or in combination. Electrolyte imbalance may impair cardiac contractility and, if severe, can be life-threatening. Hypertension further affects sodium transport pathways in the intestine, potentially leading to low sodium levels (hyponatraemia). Clinical manifestations include headache, irritability, muscle weakness, slurred speech, increased thirst, and lethargy. The risk of hyponatraemia and electrolyte imbalance is higher in individuals with hypertension who are taking diuretics, medications that increase urine output.
All these changes in the digestive system tend to further elevate blood pressure, thereby aggravating organ damage and creating a vicious cycle. Prevention lies in effective blood pressure control through lifestyle modification and strict compliance with prescribed medications.
Healthy, timely meals; a regular sleep–wake cycle; routine physical activity; stress management; and avoidance of alcohol and tobacco are essential in maintaining both cardiovascular and digestive health. Adequate intake of vitamins A, D, C, and E, as well as B-complex vitamins—particularly B6 and B12—supports optimal gut function. These nutrients can be obtained from green leafy vegetables, fresh fruits, berries, whole grains, dairy products, mushrooms, and nuts.
By adopting these simple yet effective measures, the digestive system can be kept healthy even in individuals living with hypertension.
Dr. Rachna Pande is a specialist in internal medicine.