Background: The renin-angiotensin system (RAS) is an important enzymatic system
responsible for the regulation of biological functions, such as the arterial pressure, hydroelectrolytic
control, vascular vasodilatation/vasoconstriction and more recently metabolic functions.
Objectives: The aim of the present review is to discuss the associations between the gut microbiome
and the renin-angiotensin system and the influence of their intimate relationship on the cardiovascular
Methods: A literature review of the main studies published regarding the relationship among the
renin-angiotensin system, gut microbiota and cardiovascular health was performed.
Results: The association between the ACE2 and gut microbiota has been discussed. It is shown that
the ACE2/Ang 1-7 axis modulates the immune response, influencing the microbiota composition,
and thus being one of the causes for some diseases physiophatologies, such as diarrhea and intestinal
Conclusion: The association between RAS and gut microbiota seems to have a strong influence on
the genesis of cardiovascular diseases, through direct mechanisms, such as nerve stimulation, or
indirectly on metabolic parameters, such as weight, adiposity and lipid profile.