| Title: | Effect of hypertension on long-term adverse clinical outcomes and liver fibrosis progression in MASLD |
| Journal: | Journal of Hepatology |
| Published: | 23 Aug 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40854336/ |
| DOI: | https://doi.org/10.1016/j.jhep.2025.08.017 |
Publication 19677
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Abstract
BACKGROUND & AIMS: Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension with the risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD.</p>
METHODS: Three multicenter large cohorts were analyzed: the UK Biobank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression. Adverse clinical outcomes were defined as all-cause mortality, cardiovascular events, and/or liver-related events. Liver stiffness progression was defined as an increase in liver stiffness measurement from <10 kPa to ≥10 kPa or an increase of ≥20% for baseline liver stiffness measurement ≥10 kPa. Liver fibrosis progression was defined as a 1-stage fibrosis stage increase. Cox regression and Kaplan-Meier analyses were used to evaluate the impact of baseline hypertension on outcomes.</p>
RESULTS: A total of 107,316 adults from the UKBB cohort, 8,169 from the VCTE-Prognosis cohort, and 1,670 from the Paired Liver Biopsy cohort were included. The prevalence of hypertension was 37.1%, 33.4%, and 48.9%, respectively. In the UKBB cohort, hypertension was associated with long-term adverse clinical outcomes (adjusted hazard ratio [HR] 1.30, 95% CI 1.26-1.33, p <0.001). In the VCTE-Prognosis cohort, hypertension was associated with a higher risk of liver stiffness progression (adjusted HR 1.57, 95% CI 1.30-1.90, p <0.001), while in the Paired Liver Biopsy cohort, hypertension was associated with a greater risk of histologic liver fibrosis progression (adjusted HR 1.41, 95% CI 1.12-1.78, p = 0.004). Subgroup and sensitivity analyses supported these findings.</p>
CONCLUSIONS: Hypertension is a modifiable risk factor that increases the risk of adverse clinical outcomes and progression of liver stiffness and fibrosis in MASLD.</p>
IMPACT AND IMPLICATIONS: This study provides robust evidence from three large multicenter cohorts demonstrating that hypertension is independently associated with increased risks of adverse clinical outcomes and liver fibrosis progression in individuals with MASLD. These findings reveal that hypertension, traditionally managed from a cardiovascular perspective, also plays a critical and underrecognized role in liver disease progression, making them highly relevant for hepatologists, cardiologists, and primary care providers. Incorporating non-invasive fibrosis assessments into routine care for patients with MASLD and hypertension may facilitate early risk stratification and support targeted interventions to reduce both hepatic and cardiovascular complications.</p>
16 Keywords
- Adult
- Aged
- Biopsy
- Cohort Studies
- Disease Progression
- Fatty Liver
- Female
- Humans
- Hypertension
- Liver
- Liver Cirrhosis
- Male
- Middle Aged
- Prognosis
- Risk Factors
- United Kingdom
160 Authors
- Xiao-Dong Zhou
- Li-You Lian
- Qin-Fen Chen
- Seung Up Kim
- Terry Cheuk-Fung Yip
- Salvatore Petta
- Atsushi Nakajima
- Emmanuel Tsochatzis
- Junping Shi
- Wah-Kheong Chan
- Jérôme Boursier
- Elisabetta Bugianesi
- Yusuf Yilmaz
- Hannes Hagström
- Manuel Romero-Gomez
- Khalid Alswat
- José Luis Calleja
- Hirokazu Takahashi
- Victor de Lédinghen
- Shalimar
- Laurent Castéra
- Arun J. Sanyal
- George Boon-Bee Goh
- Philip N. Newsome
- Jian-Gao Fan
- Michelle Lai
- Sandeep Aggarwal
- Stergios Kechagias
- Yoichi Hiasa
- Bheesham Dayal
- Zhongtao Zhang
- Jacob George
- Mohamed El-Kassas
- Jinjun Chen
- Hong You
- Barham K. Abu Dayyeh
- Huiping Sheng
- Leon A. Adams
- Jing Wang
- Fangping He
- Huiqing Liang
- Yong-Feng Yang
- Xiaoling Chi
- Bihui Zhong
- Yan Bi
- Yuqiang Mi
- Yongfen Zhu
- Rixing Bai
- Jing Zhang
- Bingyuan Wang
- Jinghai Song
- Hong Deng
- Qing Xie
- Lang Bai
- Yongning Xin
- Wen Xie
- Jie Li
- Céline Fournier-Poizat
- Mirko Zoncapè
- Tianyi Xia
- Shenghong Ju
- Chutian Wu
- Hye Won Lee
- Grace Lai-Hung Wong
- Angelo Armandi
- Ying Shang
- Grazia Pennisi
- Elba Llop
- Masato Yoneda
- Marc de Saint-Loup
- Clemence M. Canivet
- Carmen Lara-Romero
- Rocio Gallego-Durán
- Paloma Carrillo-Fernández
- Amon Asgharpour
- Kevin Kim-Jun Teh
- Sara Mahgoub
- Mandy Sau-Wai Chan
- Huapeng Lin
- Wen-Yue Liu
- Sherlot Juan Song
- Waleed K. Al-Hamoudi
- Hiroshi Isoda
- Teruki Miyake
- Sanjaya K. Satapathy
- Mengyi Li
- Keshni Sharma
- Mohammed Emadeldeen
- Ling Zhou
- Xiaofei Tong
- Fateh Bazerbachi
- Xiaotang Fan
- Huanming Xiao
- Junzhao Ye
- Liang Xu
- Xiaolin Wang
- Giovanni Targher
- Christopher D. Byrne
- Michael D. Shapiro
- Frank Tacke
- Vincent Wai-Sun Wong
- Ming-Hua Zheng
- Arun J. Sanyal
- Atsushi Nakajima
- Elisabetta Bugianesi
- Emmanuel Tsochatzis
- George Boon-Bee Goh
- Hannes Hagström
- Jérôme Boursier
- José Luis Calleja
- Manuel Romero-Gomez
- Ming-Hua Zheng
- Philip N. Newsome
- Salvatore Petta
- Seung Up Kim
- Victor de Lédinghen
- Vincent Wai-Sun Wong
- Wah-Kheong Chan
- Barham K. Abu Dayyeh
- Bheesham Dayal
- Bihui Zhong
- Bingyuan Wang
- Chutian Wu
- Fangping He
- Hirokazu Takahashi
- Hong Deng
- Hong You
- Huiping Sheng
- Huiqing Liang
- Jacob George
- Jérôme Boursier
- Jie Li
- Jing Wang
- Jing Zhang
- Jinghai Song
- Jinjun Chen
- Junping Shi
- Khalid Alswat
- Lang Bai
- Leon A. Adams
- Ming-Hua Zheng
- Mohamed El-Kassas
- Qing Xie
- Rixing Bai
- Salvatore Petta
- Sandeep Aggarwal
- Shalimar
- Stergios Kechagias
- Vincent Wong
- Wah Kheong Chan
- Wen Xie
- Xiaoling Chi
- Yan Bi
- Yoichi Hiasa
- Yongfen Zhu
- Yong-Feng Yang
- Yongning Xin
- Yuqiang Mi
- Yusuf Yilmaz
- Zhongtao Zhang
1 Application
| Application ID | Title |
|---|---|
| 151193 | Combining imaging data with genomic and phenotypic data to improve the whole-course management of human noncommunicable diseases |
Enabling scientific discoveries that improve human health