The gut-immune axis is a novel phenomenon that links the gut microbiome and the immune system, playing a crucial role in hypertension and cardiovascular diseases (CVDs). Dysbiosis, or alterations in gut microbial composition, can trigger chronic low-grade inflammation, leading to the development and progression of hypertension and CVDs. The gut microbiome, influenced by diet, diet fiber, and other factors, produces metabolites such as short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), which mediate communication between the gut and peripheral organs via the immune system. SCFAs, particularly butyrate, have anti-inflammatory properties and can reduce blood pressure and inflammation. TMAO, derived from phosphatidylcholine, choline, and carnitine, promotes atherosclerosis and increases cardiovascular risk. The gut-brain axis, involving bidirectional communication between the gut microbiota and the brain, also influences immune responses and can affect stroke outcomes. Modulating the gut microbiome, particularly through diet, may be a therapeutic approach to reduce blood pressure and improve CVD recovery.The gut-immune axis is a novel phenomenon that links the gut microbiome and the immune system, playing a crucial role in hypertension and cardiovascular diseases (CVDs). Dysbiosis, or alterations in gut microbial composition, can trigger chronic low-grade inflammation, leading to the development and progression of hypertension and CVDs. The gut microbiome, influenced by diet, diet fiber, and other factors, produces metabolites such as short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), which mediate communication between the gut and peripheral organs via the immune system. SCFAs, particularly butyrate, have anti-inflammatory properties and can reduce blood pressure and inflammation. TMAO, derived from phosphatidylcholine, choline, and carnitine, promotes atherosclerosis and increases cardiovascular risk. The gut-brain axis, involving bidirectional communication between the gut microbiota and the brain, also influences immune responses and can affect stroke outcomes. Modulating the gut microbiome, particularly through diet, may be a therapeutic approach to reduce blood pressure and improve CVD recovery.