The gut-immune axis plays a critical role in the development and progression of hypertension and cardiovascular diseases (CVDs). The gut microbiome influences immune responses and inflammation, which are key factors in these conditions. Dysbiosis, or imbalance in the gut microbiota, can lead to chronic low-grade inflammation, contributing to hypertension, atherosclerosis, heart failure, and stroke. The gut microbiome is also involved in the production of metabolites such as short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), which can affect systemic inflammation and cardiovascular risk. Diet is a major modulator of the gut microbiota, with high-sodium and high-fat diets promoting gut dysbiosis and increasing the risk of CVDs. SCFAs, produced by gut bacteria, have anti-inflammatory effects and may help reduce blood pressure and improve cardiovascular outcomes. TMAO, produced from dietary components like choline and carnitine, is associated with increased cardiovascular risk. The gut-immune axis is also involved in the brain-gut-brain communication, influencing neurological outcomes after stroke. Understanding the interactions between the gut microbiome, immune system, and inflammation is essential for developing new therapeutic strategies to prevent and treat hypertension and CVDs.The gut-immune axis plays a critical role in the development and progression of hypertension and cardiovascular diseases (CVDs). The gut microbiome influences immune responses and inflammation, which are key factors in these conditions. Dysbiosis, or imbalance in the gut microbiota, can lead to chronic low-grade inflammation, contributing to hypertension, atherosclerosis, heart failure, and stroke. The gut microbiome is also involved in the production of metabolites such as short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), which can affect systemic inflammation and cardiovascular risk. Diet is a major modulator of the gut microbiota, with high-sodium and high-fat diets promoting gut dysbiosis and increasing the risk of CVDs. SCFAs, produced by gut bacteria, have anti-inflammatory effects and may help reduce blood pressure and improve cardiovascular outcomes. TMAO, produced from dietary components like choline and carnitine, is associated with increased cardiovascular risk. The gut-immune axis is also involved in the brain-gut-brain communication, influencing neurological outcomes after stroke. Understanding the interactions between the gut microbiome, immune system, and inflammation is essential for developing new therapeutic strategies to prevent and treat hypertension and CVDs.