NAFLD a risk factor for young-onset hypertension

Young people with nonalcoholic fatty liver disease (NAFLD) are at increased risk of hypertension, especially women and those with more severe hepatic steatosis, as shown in a study.

The study included 85,789 women and 67,553 men who were <40 years of age and hypertension-free at baseline. They underwent liver ultrasound to assess hepatic steatosis, which was then classified as mild or moderate/severe. Those who had a blood pressure (BP) of ≥130/80 mm Hg, self-reported history of physician-diagnosed hypertension, or were currently using BP-lowering medications were considered hypertensive.

Researchers used Cox proportional hazard models to examine whether NAFLD had any influence on the incidence of young-onset hypertension, and if the association was modified by sex.

Over a median follow-up of 4.5 years, hypertension occurred in a total of 25,891 participants. The resulting incidence rates were 15.6 per 10,000 person-years for women and 63.5 per 10,000 person-years for men.

Multivariable analysis showed that the risk of incident hypertension was elevated in the presence of NAFLD. When compared with those who had no NAFLD, participants with mild or moderate/severe NAFLD had greater risk increase, especially for female participants (adjusted hazard ratio [HR], 1.68, 95 percent confidence interval [CI], 1.56–1.80 and adjusted HR, 1.83, 95 percent CI, 1.60–2.09, respectively) than male participants (adjusted HR, 1.21, 95 percent CI, 1.17–1.25 and adjusted HR, 1.23, 95 percent CI, 1.17–1.30, respectively).

The association between NAFLD and incident hypertension was consistently seen among female participants, regardless of obesity/central obesity (p<0.001 for all).