Dysbiosis Malaria and Hypertension: The Mechanistic Links

According to new research, dysbiosis is a crucial link between chronic non-communicable diseases and infectious diseases. This review examines how malaria-induced dysbiosis and hypertension may exacerbate gut dysbiosis and summarizes the current understanding of the mechanisms underlying this relationship. Reduced microbial diversity, fewer bacteria that produce short-chain fatty acids (SCFAs), and elevated levels of pro-hypertensive metabolites such as trimethylamine-N-oxide (TMAO) and lipopolysaccharides (LPS) are the hallmarks of dysbiosis in hypertension. These changes result in increased gut permeability, endothelial dysfunction, and systemic inflammation, all of which raise blood pressure. At the same time, parasite toxins from Plasmodium infection cause severe gut dysbiosis (e.g., hemozoin), systemic inflammation (TNF-α, IFN-γ), and related malnutrition. This dysbiosis linked to Malaria weakens the integrity of the gut barrier and impairs immune regulation, resulting in a leaky gut and a pro-inflammatory phenotype. We proposed that the dysbiotic state brought on by acute or recurrent Malaria may act as a latent risk factor, setting up the host environment for the emergence of hypertension via persistent barrier dysfunction, impaired SCFA signaling, and prolonged inflammation. This intersection implies that novel approaches to reducing the risk of hypertension in malaria-endemic populations may involve microbiome-targeted interventions.

Dysbiosis, Hypertension, Malaria, Gut Microbiome

1. Ataide, R., Hasenkamp, L., Fernandez, S. T., Menard, D., D'Alessandro, U., van den Abbeele, J., Sonden, K., Märtensson, A., Petzold, M., Saggu, G. S., Huang, Y., Lim, P., Sattabongkot, J., & Doolan, D. L. (2020). The placenta harbors a unique microbiome in Plasmodium falciparum and Plasmodium vivax infections. Nature Medicine, 26(12), 1968–1974. https://doi.org/10.1038/s41591-020-01056-2 [Google Scholar] [Crossref]

2. Awah-Nanzdum, A., Metoh, T., Mbifung, M., Fru, C., Djouosseu, A., Yensii, N., Bongjo, N., Ngo-Matip, M., & Mbofung, C. (2023). Inter-Relationship between Malaria, Probiotic Food Intake, and Gut Microbiota Status among Malaria Patients. Journal of Biomedical Research & Environmental Sciences. https://doi.org/10.37871/jbres1715. [Google Scholar] [Crossref]

3. Bae, H., Leung, P., Hodge, D., Fenimore, J., Jeon, S., Thovarai, V., Dzutsev, A., Welcher, A., Boedigheimer, M., Damore, M., Choi, M., Fravell, R., Trinchieri, G., Gershwin, M., & Young, H. (2020). Multi-omics: Differential expression of IFN-γ results in distinctive mechanistic features linking chronic inflammation, gut dysbiosis, and autoimmune diseases. Journal of autoimmunity, 102436. https://doi.org/10.1016/j.jaut.2020.102436. [Google Scholar] [Crossref]

4. Bangs, M. J., van Leeuwen, E., Farag, M., & Bousema, T. (2022). Gut microbiome alterations in severe falciparum malaria. Gut Microbes, 14(1), Article 2041364. https://doi.org/10.1080/19490976.2022.2041364 [Google Scholar] [Crossref]

5. Calderón-Pérez, L., Gosalbes, M., Yuste, S., Valls, R., Pedret, A., Llauradó, E., Jimenéz-Hernandéz, N., Artacho, A., Pla-Pagà, L., Companys, J., Ludwig, I., Romero, M., Rubió, L., & Solà, R. (2020). Gut metagenomic and short-chain fatty acids signature in hypertension: a cross-sectional study. Scientific Reports, 10. https://doi.org/10.1038/s41598-020-63475-w. [Google Scholar] [Crossref]

6. Canyelles, M., Borràs, C., Rotllan, N., Tondo, M., Escolà-Gil, J., & Blanco-Vaca, F. (2023). Gut Microbiota-Derived TMAO: A Causal Factor Promoting Atherosclerotic Cardiovascular Disease? International Journal of Molecular Sciences, 24. https://doi.org/10.3390/ijms24031940. [Google Scholar] [Crossref]

7. Costa, F. T., Lopes, S. C. P., Albrecht, L., Ataide, R., Siqueira, A. M., Souza, R. M., Russell, B., Rénia, L., Marinho, C. R., & Lacerda, M. V. G. (2021). On the pathogenesis of Plasmodium vivax malaria: Perspectives from the blood circulation, liver, and microbiota. Frontiers in Immunology, 9, Article 2477. https://doi.org/10.3389/fimmu.2018.02477 (Note: Adapted for vivax-gut focus) [Google Scholar] [Crossref]

8. Das, D., Grais, R., Okiro, E., Stepniewska, K., Mansoor, R., Kam, S., Terlouw, D., Terlouw, D., Terlouw, D., Tarning, J., Tarning, J., Barnes, K., & Guerin, P. (2018). Complex interactions between Malaria and malnutrition: a systematic literature review. BMC Medicine, 16. https://doi.org/10.1186/s12916-018-1177-5. [Google Scholar] [Crossref]

9. David, B. (2025). The Role of Gut Microbiome Diversity in Modulating Malaria Severity among Children Under Five. RESEARCH INVENTION JOURNAL OF PUBLIC HEALTH AND PHARMACY. https://doi.org/10.59298/rijpp/2025/416165. [Google Scholar] [Crossref]

10. Del Bo', C., Bernardi, S., Cherubini, A., Porrini, M., Gargari, G., Hidalgo-Liberona, N., González-Domínguez, R., Zamora-Ros, R., Peron, G., Marino, M., Gigliotti, L., Winterbone, M., Kirkup, B., Kroon, P., Andrés-Lacueva, C., Guglielmetti, S., & Riso, P. (2020). A polyphenol-rich dietary pattern improves intestinal permeability, as assessed by serum zonulin levels, in older subjects: The MaPLE randomised controlled trial. Clinical nutrition. https://doi.org/10.1016/j.clnu.2020.12.014. [Google Scholar] [Crossref]

11. Deng, W., Zhu, M., Lloyd, I., Nedunuri, M., Zhou, C., Liu, W., Li, Y., Li, Q., Wang, X., Zhang, Q., Jhuma, T. A., Li, J., & Yang, T. (2025). Beyond the Microbiome: The Gut's Role in Hypertension. Function (Oxford, England), 6(5), zqaf037. https://doi.org/10.1093/function/zqaf037 [Google Scholar] [Crossref]

12. Denny, J., & Schmidt, N. (2019). Oral Administration of Clinically Relevant Antimalarial Drugs Does Not Modify the Murine Gut Microbiota. Scientific Reports, 9. https://doi.org/10.1038/s41598-019-48454-0. [Google Scholar] [Crossref]

13. De Villiers, K., & Egan, T. (2021). Heme Detoxification in the Malaria Parasite: A Target for Antimalarial Drug Development. Accounts of chemical research. https://doi.org/10.1021/acs.accounts.1c00154. [Google Scholar] [Crossref]

14. Douglas, A. E., Varian, B. J., & Rajagopal, S. (2022). The gut microbiome modulates host immunity and protects against cerebral Malaria. Cell Host & Microbe, 30(10), 1400–1415.e7. https://doi.org/10.1016/j.chom.2022.09.006 [Google Scholar] [Crossref]

15. Douglas, A. E., Varian, B. J., Rajagopal, S., & Venugopal, K. (2023). Humanized microbiota models reveal conserved malaria-microbiome interactions. Cell Reports, 42(5), Article 112456. https://doi.org/10.1016/j.celrep.2023.112456 [Google Scholar] [Crossref]

16. Fan, L., Chen, J., Zhang, Q., Ren, J., Chen, Y., Yang, J., Wang, L., Guo, Z., Bu, P., Zhu, B., Zhao, Y., Wang, Y., Liu, X., Wang, W., Chen, Z., Gao, Q., Zheng, L., & Cai, J. (2025). Fecal microbiota transplantation for hypertension: an exploratory, multicenter, randomized, blinded, placebo-controlled trial. Microbiome, 13. https://doi.org/10.1186/s40168-025-02118-6. [Google Scholar] [Crossref]

17. Felizardo, R., Felizardo, R., Watanabe, I., Watanabe, I., Dardi, P., Rossoni, L., & Câmara, N. (2019). The interplay among gut microbiota, hypertension, and kidney diseases: The role of short-chain fatty acids. Pharmacological research, 141, 366-377. https://doi.org/10.1016/j.phrs.2019.01.019. [Google Scholar] [Crossref]

18. Fusco, E., Bower, L., Polidoro, R., Minns, A., Lindner, S., & Schmidt, N. (2025). Microbiome-mediated modulation of immune memory to P. yoelii affects the resistance to secondary cerebral malaria challenge. ImmunoHorizons, 9. https://doi.org/10.1093/immhor/vlaf009. [Google Scholar] [Crossref]

19. Garnie, L., Egan, T., & Wicht, K. (2025). Heme Detoxification in the Malaria Parasite Plasmodium falciparum: A Time-Dependent Basal-Level Analysis. bioRxiv. https://doi.org/10.1101/2025.03.06.641703. [Google Scholar] [Crossref]

20. Ge, Y., Wang, J., Wu, L., & Wu, J. (2024). Gut microbiota: a potential new regulator of hypertension. Frontiers in cardiovascular Medicine, 11, 1333005. https://doi.org/10.3389/fcvm.2024.1333005 [Google Scholar] [Crossref]

21. Gomes, P., Mannochio-Russo, H., Lablokov, S., Rodionov, D., Yang, H., Dorrestein, P., Peterson, S., & Peterson, C. (2025). Ex Vivo Interaction Between Human Gut Microbiota and Artemisinin: A Multi-Omics Perspective. ACS Omega, 10, 21929–21938. https://doi.org/10.1021/acsomega.5c01983. [Google Scholar] [Crossref]

22. Haldar, K., Das Mohapatra, P., & Mohanty, A. K. (2018). Plasmodium falciparum var genes and cerebral Malaria: Do they play a role in gut dysbiosis? Nature Reviews Microbiology, 16(5), 285–286. https://doi.org/10.1038/nrmicro.2018.25 [Google Scholar] [Crossref]

23. He, S., & Qi, Y. (2025). The microbiota, the malarial parasite, and the mice—a three-sided relationship. Frontiers in Microbiology, 16. https://doi.org/10.3389/fmicb.2025.1615846. [Google Scholar] [Crossref]

24. Javelle, E., Mayet, A., Million, M., Levasseur, A., Allodji, R., Marimoutou, C., Lavagna, C., Desplans, J., Fournier, P., Raoult, D., & Texier, G. (2021). Gut Microbiota in Military International Travelers with Doxycycline Malaria Prophylaxis: Towards the Risk of a Simpson Paradox in the Human Microbiome Field. Pathogens, 10. https://doi.org/10.3390/pathogens10081063. [Google Scholar] [Crossref]

25. Jiang, S., Shui, Y., Cui, Y., Tang, C., Wang, X., Qiu, X., Hu, W., Fei, L., Li, Y., Zhang, S., Zhao, L., Xu, N., Dong, F., Ren, X., Liu, R., Persson, P., Patzak, A., Lai, E., Wei, Q., & Zheng, Z. (2021). Gut microbiota-dependent trimethylamine N-oxide aggravates angiotensin II–induced hypertension. Redox Biology, 46. https://doi.org/10.1016/j.redox.2021.102115. [Google Scholar] [Crossref]

26. Kalantari, P., DeOliveira, R., Chan, J., Corbett, Y., Rathinam, V., Stutz, A., Latz, E., Gazzinelli, R., Golenbock, D., & Fitzgerald, K. (2014). Dual engagement of the NLRP3 and AIM2 inflammasomes by plasmodium-derived hemozoin and DNA during Malaria. Cell Reports, 6 (1), 196–210. https://doi.org/10.1016/j.celrep.2013.12.014. [Google Scholar] [Crossref]

27. Kim, S., Goel, R., Kumar, A., Qi, Y., Lobaton, G., Hosaka, K., Mohammed, M., Handberg, E., Richards, E., Pepine, C., & Raizada, M. (2018). Imbalance of gut microbiome and intestinal epithelial barrier dysfunction in patients with high blood pressure. Clinical science, 132 6, 701–718. https://doi.org/10.1042/cs20180087. [Google Scholar] [Crossref]

28. Kers, J. G., & Saccenti, E. (2022). The Power of Microbiome Studies: Some Considerations on Which Alpha and Beta Metrics to Use and How to Report Results. Frontiers in microbiology, 12, 796025. https://doi.org/10.3389/fmicb.2021.796025 [Google Scholar] [Crossref]

29. Lasaviciute, G., Tariq, K., Sugathan, A., Quin, J., Polenkowski, M., Bujila, I., Skorokhod, O., Troye-Blomberg, M., Sverremark-Ekström, E., & Farrants, Ö. (2025). Malaria-derived hemozoin skews dendritic cell responses to bacterial infections by reducing interferon gene transcription by SWI/SNF-NuRD. iScience, 28. https://doi.org/10.1016/j.isci.2025.113046. [Google Scholar] [Crossref]

30. Li, J., Zhao, F., Wang, Y., Chen, J., Tao, J., Tian, G., Wu, S., Liu, W., Cui, Q., Geng, B., Zhang, W., Weldon, R., Auguste, K., Yang, L., Liu, X., Chen, L., Yang, X., Zhu, B., & Cai, J. (2017). Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome, 5. https://doi.org/10.1186/s40168-016-0222-x. [Google Scholar] [Crossref]

31. Li, C., Xiao, P., Lin, D., Zhong, H., Zhang, R., Zhao, Z., & He, X. (2021). Risk Factors for Intestinal Barrier Impairment in Patients With Essential Hypertension. Frontiers in Medicine, 7. https://doi.org/10.3389/fmed.2020.543698. [Google Scholar] [Crossref]

32. Lin, L., Xu, S., Cai, M., Li, S., Chen, Y., Chen, L., & Lin, Y. (2024). Effects of fecal microbiota transfer on blood pressure in animal models: A systematic review and meta-analysis. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0300869. [Google Scholar] [Crossref]

33. Loevenich, K., Ueffing, K., Abel, S., Hose, M., Matuschewski, K., Westendorf, A., Buer, J., & Hansen, W. (2017). DC-Derived IL-10 Modulates Pro-Inflammatory Cytokine Production and Promotes Induction of CD4+IL-10+ Regulatory T Cells during Plasmodium yoelii Infection—Frontiers in Immunology, 8. https://doi.org/10.3389/fimmu.2017.00152. [Google Scholar] [Crossref]

34. Luqman, A., Hassan, A., Ullah, M., Naseem, S., Ullah, M., Zhang, L., Din, A., Ullah, K., Ahmad, W., & Wang, G. (2024). Role of the intestinal microbiome and its therapeutic intervention in cardiovascular disorders. Frontiers in Immunology, 15. https://doi.org/10.3389/fimmu.2024.1321395. [Google Scholar] [Crossref]

35. M, A. (2025). Integrating Nutritional Interventions in Malaria and Anemia Management: Strategies for Effective Public Health Initiatives. RESEARCH INVENTION JOURNAL OF BIOLOGICAL AND APPLIED SCIENCES. https://doi.org/10.59298/rijbas/2025/524853. [Google Scholar] [Crossref]

36. Mandal, R., Crane, R., Berkley, J., Gumbi, W., Wambua, J., Ngoi, J., Ndungu, F., & Schmidt, N. (2018). Longitudinal Analysis of Infant Stool Bacteria Communities Before and After Acute Febrile Malaria and Artemether-Lumefantrine Treatment. The Journal of Infectious Diseases, 220, 687–698. https://doi.org/10.1093/infdis/jiy740. [Google Scholar] [Crossref]

37. Mandal, R., & Schmidt, N. (2023). Mechanistic insights into the interaction between the host gut microbiome and Malaria. PLOS Pathogens, 19. https://doi.org/10.1371/journal.ppat.1011665. [Google Scholar] [Crossref]

38. Mardanparvar, H. (2025). Aggravation of hypertension by gut microbiota dysbiosis: a short review on new concepts. Journal of Renal Endocrinology. https://doi.org/10.34172/jre.2025.25185. [Google Scholar] [Crossref]

39. Mukherjee, D., Chora, Â., Lone, J., Ramiro, R., Blankenhaus, B., Serre, K., Ramirez, M., Gordo, I., Veldhoen, M., Varga-Weisz, P., & Mota, M. (2022). Host lung microbiota promotes malaria-associated acute respiratory distress syndrome. Nature Communications, 13. https://doi.org/10.1038/s41467-022-31301-8. [Google Scholar] [Crossref]

40. Mutapi, F., Mduluza, T., & Woolhouse, M. E. J. (2023). Malaria and the microbiome: Interactions and implications. Trends in Parasitology, 39(4), 289–302. https://doi.org/10.1016/j.pt.2023.01.004 [Google Scholar] [Crossref]

41. Moludi, J., Maleki, V., Jafari-Vayghyan, H., Vaghef-Mehrabany, E., & Alizadeh, M. (2020). Metabolic endotoxemia and cardiovascular disease: A systematic review about potential roles of prebiotics and probiotics. Clinical and Experimental Pharmacology and Physiology, 47, 927 - 939. https://doi.org/10.1111/1440-1681.13250. [Google Scholar] [Crossref]

42. Morffy Smith, C. D., Gong, M., Andrew, A. K., Russ, B. N., Ge, Y., Zadeh, M., Cooper, C. A., Mohamadzadeh, M., & Moore, J. M. (2019). Composition of the gut microbiota transcends genetic determinants of malaria infection severity and influences pregnancy outcome. EBioMedicine, 44, 639–655. https://doi.org/10.1016/j.ebiom.2019.05.052 [Google Scholar] [Crossref]

43. Murr, N., Olender, T., Smith, M., Smith, A., Pilotos, J., Richard, L., Mowa, C., & Opata, M. (2021). Plasmodium chabaudi Infection Alters Intestinal Morphology and Mucosal Innate Immunity in Moderately Malnourished Mice. Nutrients, 13. https://doi.org/10.3390/nu13030913. [Google Scholar] [Crossref]

44. Mutoni, J., Van Hul, M., Uwimana, A., Petitfils, C., Wong, G., Puel, A., Everard, A., Alexiou, H., Mutesa, L., Coutelier, J., Rujeni, N., & Cani, P. (2025). Differences in gut microbiota composition are associated with geographic location and age in malaria-endemic regions of Rwanda. PLOS One, 20. https://doi.org/10.1371/journal.pone.0320698. [Google Scholar] [Crossref]

45. Nogal, A., Valdes, A., & Menni, C. (2021). The role of short-chain fatty acids in the interplay between gut microbiota and diet in cardio-metabolic health. Gut Microbes, 13. https://doi.org/10.1080/19490976.2021.1897212. [Google Scholar] [Crossref]

46. Ntlahla, E., Mfengu, M., Engwa, G., Nkeh-Chungag, B., & Sewani-Rusike, C. (2021). Gut permeability is associated with hypertension and measures of obesity, but not with Endothelial Dysfunction in South African youth. African Health Sciences. https://doi.org/10.4314/ahs.v21i3.26. [Google Scholar] [Crossref]

47. Obeagu, E. (2024). Role of cytokines in immunomodulation during malaria clearance. Annals of Medicine and Surgery, 86, 2873–2882. https://doi.org/10.1097/ms9.0000000000002019. [Google Scholar] [Crossref]

48. O’Donnell, J., Zheng, T., Méric, G., & Marques, F. (2023). The gut microbiome and hypertension. Nature Reviews Nephrology, 19, 153–167. https://doi.org/10.1038/s41581-022-00654-0. [Google Scholar] [Crossref]

49. Pack, A., Schwartzhoff, P., Zacharias, Z., Fernandez-Ruiz, D., Heath, W., Gurung, P., Legge, K., Janse, C., & Butler, N. (2021). Hemozoin-mediated inflammasome activation limits long-lived antimalarial immunity. Cell Reports, 36, 109586–109586. https://doi.org/10.1016/j.celrep.2021.109586. [Google Scholar] [Crossref]

50. Pan, Z., Chang, Y., Han, N., Hou, F., Lee, B., Zhi, F., Yang, R., & Bi, Y. (2020). Short-term high-dose gavage of hydroxychloroquine alters the gut microbiota but does not affect intestinal integrity or immunological responses in mice. Life Sciences, 264, 118450–118450. https://doi.org/10.1016/j.lfs.2020.118450. [Google Scholar] [Crossref]

51. Pranty, A., Szepanowski, L., Wruck, W., Karikari, A., & Adjaye, J. (2024). Hemozoin induces Malaria by activating DNA damage, p38 MAPK, and neurodegenerative pathways in a human iPSC-derived neuronal model of cerebral Malaria. Scientific Reports, 14. https://doi.org/10.1101/2024.03.08.584068. [Google Scholar] [Crossref]

52. Popa, G., & Popa, M. (2021). Recent Advances in Understanding the Inflammatory Response in Malaria: A Review of the Dual Role of Cytokines. Journal of Immunology Research, 2021. https://doi.org/10.1155/2021/7785180. [Google Scholar] [Crossref]

53. Radaelli, E., Manenti, A., Scavone, F., Albonico, F., Morosetti, P., & Crispo, A. (2021). Probiotics reduce parasitemia and inflammation in experimental Malaria. Parasites & Vectors, 14(1), 345. https://doi.org/10.1186/s13071-021-04835-2 [Google Scholar] [Crossref]

54. Reinhardt, P. H., Weiss, W. R., & Richie, T. L. (2022). Plasmodium species-specific modulation of the murine gut microbiota. PLoS Pathogens, 18(5), Article e1010534. https://doi.org/10.1371/journal.ppat.1010534 [Google Scholar] [Crossref]

55. Samarraie, A., Pichette, M., & Rousseau, G. (2023). Role of the Gut Microbiome in the Development of Atherosclerotic Cardiovascular Disease. International Journal of Molecular Sciences, 24. https://doi.org/10.3390/ijms24065420. [Google Scholar] [Crossref]

56. Sarr, D., Andrew, A., Shukla, A., Mwalimu, S., & Moore, J. (2025). Placental Malaria Induces Oxidative Stress in Human Syncytiotrophoblast. The Journal of Infectious Diseases, 232, e174 - e185. https://doi.org/10.1093/infdis/jiaf243. [Google Scholar] [Crossref]

57. Silveira-Nunes, G., Durso, D., De Oliveira, L., Cunha, E., Maioli, T., Vieira, A., Speziali, E., Corrêa-Oliveira, R., Martins-Filho, O., Teixeira-Carvalho, A., Franceschi, C., Rampelli, S., Turroni, S., Brigidi, P., & Faria, A. (2020). Hypertension Is Associated With Intestinal Microbiota Dysbiosis and Inflammation in a Brazilian Population. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.00258. [Google Scholar] [Crossref]

58. Sriboonvorakul, N., Chotivanich, K., Silachamroon, U., Phumratanaprapin, W., Adams, J., Dondorp, A., & Leopold, S. (2023). Intestinal injury and the gut microbiota in patients with Plasmodium falciparum malaria. PLOS Pathogens, 19. https://doi.org/10.1371/journal.ppat.1011661. [Google Scholar] [Crossref]

59. Tsiavos, A., Antza, C., Trakatelli, C., & Kotsis, V. (2024). The Microbial Perspective: A Systematic Literature Review on Hypertension and Gut Microbiota. Nutrients, 16. https://doi.org/10.3390/nu16213698. [Google Scholar] [Crossref]

60. Van Den Ham, K., Bower, L., Li, S., Lorenzi, H., Doumbo, S., Doumtabe, D., Kayentao, K., Ongoiba, A., Traore, B., Crompton, P., & Schmidt, N. (2024). The gut microbiome is associated with susceptibility to febrile Malaria in Malian children. Nature Communications, 15. https://doi.org/10.1038/s41467-024-52953-8. [Google Scholar] [Crossref]

61. Vemuri, R., Ruggiero, A., Whitfield, J., Dugan, G., Cline, J., Block, M., Guo, H., & Kavanagh, K. (2022). Hypertension promotes microbial translocation and dysbiotic shifts in the fecal microbiome of non-human primates. American journal of physiology. Heart and circulatory physiology. https://doi.org/10.1152/ajpheart.00530.2021. [Google Scholar] [Crossref]

62. Veres-Székely, A., Szász, C., Pap, D., Szebeni, B., Bokrossy, P., & Vannay, Á. (2023). Zonulin as a Potential Therapeutic Target in Microbiota-Gut-Brain Axis Disorders: Encouraging Results and Emerging Questions. International journal of molecular sciences, 24(8), 7548. https://doi.org/10.3390/ijms24087548 [Google Scholar] [Crossref]

63. Verhaar, B., Prodan, A., Nieuwdorp, M., & Muller, M. (2020). Gut Microbiota in Hypertension and Atherosclerosis: A Review. Nutrients, 12. https://doi.org/10.3390/nu12102982. [Google Scholar] [Crossref]

64. Verma, A., Shrivastava, S., & Saxena, N. (2025). Malaria and malnutrition in tribal areas of India: implications for paediatric health. Frontiers in Gastroenterology. https://doi.org/10.3389/fgstr.2025.1526806. [Google Scholar] [Crossref]

65. Villarino, N., LeCleir, G., Denny, J., Dearth, S., Harding, C., Sloan, S., Gribble, J., Campagna, S., Wilhelm, S., & Schmidt, N. (2016). Composition of the gut microbiota modulates the severity of Malaria. Proceedings of the National Academy of Sciences, 113, 2235–2240. https://doi.org/10.1073/pnas.1504887113. [Google Scholar] [Crossref]

66. Waide, M., & Schmidt, N. (2020). The gut microbiome, immunity, and Plasmodium severity. Current opinion in microbiology, 58, 56–61. https://doi.org/10.1016/j.mib.2020.08.006. [Google Scholar] [Crossref]

67. Wu, Y., Xu, H., Tu, X., & Gao, Z. (2021). The Role of Short-Chain Fatty Acids of Gut Microbiota Origin in Hypertension. Frontiers in Microbiology, 12. https://doi.org/10.3389/fmicb.2021.730809. [Google Scholar] [Crossref]

68. Yan, K., Wang, S., Wang, M., Yao, Y., Liu, X., Song, J., Chen, Y., Chen, Y., Qi, R., Zhou, X., Zhong, J., Hu, C., Dong, Y., & Li, J. (2025). Modulating gut microbiota with SCFAs and high-fiber diets to mitigate PM2.5-induced hypertension in mice. Ecotoxicology and environmental safety, 302, 118696. https://doi.org/10.1016/j.ecoenv.2025.118696. [Google Scholar] [Crossref]

69. Yañez, A., Hassim, M. F., Ling, C. L., Goodier, M. R., Khan, S. M., & Riley, E. M. (2021). Gut microbiota dynamics in experimental malaria infection. Frontiers in Immunology, 12, Article 678035. https://doi.org/10.3389/fimmu.2021.678035 [Google Scholar] [Crossref]

70. Yang, T., Aquino, V., Lobaton, G., Li, H., Colon-Perez, L., Goel, R., Qi, Y., Zubcevic, J., Febo, M., Richards, E., Pepine, C., & Raizada, M. (2019). Sustained Captopril‐Induced Reduction in Blood Pressure Is Associated With Alterations in Gut‐Brain Axis in the Spontaneously Hypertensive Rat—Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 8. https://doi.org/10.1161/jaha.118.010721. [Google Scholar] [Crossref]

71. Yang, F., Chen, H., Gao, Y., An, N., Li, X., Pan, X., Yang, X., Tian, L., Sun, J., Xiong, X., & Xing, Y. (2020). Gut microbiota-derived short-chain fatty acids and hypertension: Mechanism and treatment. Biomedicine & pharmacotherapy; 130, 110503. https://doi.org/10.1016/j.biopha.2020.110503. [Google Scholar] [Crossref]

72. Yang, Z., Wang, Q., Liu, Y., Wang, L., Ge, Z., Li, Z., Feng, S., & Wu, C. (2023). Gut microbiota and hypertension: association, mechanisms and treatment. Clinical and Experimental Hypertension, 45. https://doi.org/10.1080/10641963.2023.2195135. [Google Scholar] [Crossref]

73. Yegorov, S., Joosten, S. A., & Ottenhoff, T. H. M. (2020). The role of the gut microbiome in infectious diseases: Mechanisms and therapeutic opportunities. mBio, 11(3), Article e00858-20. https://doi.org/10.1128/mBio.00858-20 (Malaria-inclusive) [Google Scholar] [Crossref]

74. Xu, X., Jin, H., Li, X., Yan, C., Zhang, Q., Yu, X., Liu, Z., Liu, S., & Zhu, F. (2024). Fecal Microbiota Transplantation Regulates Blood Pressure by Altering Gut Microbiota Composition and Intestinal Mucosal Barrier Function in Spontaneously Hypertensive Rats. Probiotics and antimicrobial proteins. https://doi.org/10.1007/s12602-024-10344-x. [Google Scholar] [Crossref]

75. Zhen, J., Zhou, Z., He, M., Han, H., Lv, E., Wen, P., Liu, X., Wang, Y., Cai, X., Tian, J., Zhang, M., Xiao, L., & Kang, X. (2023). The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1085041. [Google Scholar] [Crossref]

76. Zhong, H., Zeng, H., Cai, Y., Zhuang, Y., Liou, Y., Wu, Q., & He, X. (2021). Washed Microbiota Transplantation Lowers Blood Pressure in Patients With Hypertension. Frontiers in Cellular and Infection Microbiology, 11. https://doi.org/10.3389/fcimb.2021.679624. [Google Scholar] [Crossref]

• Measuring Waste of Patient Time in Health Care at Non-Digitized Hospital: An Observational Study in Bangabandhu Sheikh Mujib Medical University, Bangladesh
• Reaffirming Clinical Confidence in Atorvastatin Therapy: A Digital Outreach Case Study from Tamil Nadu, India
• Clinical Manifestations and Therapeutic Response in a Patient with Hypothyroidism: A Case Report
• Eranda (Ricinus Communis) In Gridhrasi (Sciatica): Classical Rationale, Pharmacology and Clinical Evidence- A Narrative Literature Review
• Magnetotherapy in Pain Management: Mechanisms, Clinical Applications, and Future Perspectives – A Review