Development of new fatty liver, or resolution of existing fatty liver, over five years of follow-up, and risk of incident hypertension

Ki-Chul Sung, Sarah H. Wild, Christopher D. Byrne

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Background & Aims: Approximately 50% of hypertensive patients have non-alcoholic fatty liver disease (NAFLD), but whether change in fatty liver status over time modifies risk of developing hypertension is uncertain. Our aim was to determine whether a change in fatty liver status (either development of new fatty liver, or resolution of existing fatty liver) over five years modified risk of incident hypertension at five year follow-up.

Methods: 11,448 patients without hypertension were examined at baseline and at five year follow-up, using a retrospective cohort study design. Fatty liver status (absent or present) was assessed at baseline and follow-up using standard ultrasound criteria. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for incident hypertension at follow-up were estimated controlling for potential confounders, compared to the reference group (patients who did not have fatty liver at either baseline or follow-up).

Results: 911 patients developed incident hypertension. Incident fatty liver developed during follow-up in 1418 patients and fatty liver at baseline resolved during follow-up in 684 patients. Developing incident fatty liver was associated with incident hypertension, even after adjustment for multiple confounders (aOR = 1.60 (95% CI 1.30, 1.96; p <0.001). Further adjustment for change in body mass index between baseline and follow-up only slightly attenuated this association (aOR = 1.36 (95% CI 1.10, 1.67; p = 0.004). With resolution of fatty liver at follow-up, risk of incident hypertension was not different from the reference group (aOR = 1.21 (95% CI 0.90, 1.63; p = 0.21).

Conclusions: Development of incident fatty liver is associated with increased risk of hypertension. (c) 2014 European Association for the Study of the Liver. Published by Elsevier B. V. All rights reserved.

Original languageEnglish
Pages (from-to)1040-1045
Number of pages6
JournalJournal of Hepatology
Issue number5
Publication statusPublished - May 2014


  • Non-alcoholic fatty liver disease
  • Hypertension
  • Type 2 diabetes
  • Obesity
  • Insulin resistance
  • Metabolic syndrome.

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