Increased Levels of Systolic Blood Pressure Within the Normal Range Are Associated With Significantly Elevated Risks of Nonalcoholic Fatty Liver Disease

Abstract

A positive association between hypertension or high-normal blood pressure (BP) and risk of nonalcoholic fatty liver disease (NAFLD) is well-known; however, no data have been generated exploring the risk of NAFLD within the normal range of BP. We aimed to assess the association between normal systolic blood pressure (SBP) and risk of NAFLD.A total of 27,769 subjects from 2 separate medical centers were included. Subjects were divided into 4 groups (G1 to G4) by SBP levels: G1: 90–99 mmHg, G2: 100–109 mmHg, G3: 110–119 mmHg, and G4: 120–129 mmHg. The prevalence, hazard ratios (HRs) and 95% confidence intervals (CIs) for NAFLD were calculated across each group, using the G1 as reference.Higher SBP was observed in subjects with NAFLD than those without NAFLD. The prevalence of NAFLD in a cross-sectional population from G1 to G4 was 6.1%, 13.6%, 19.6%, and 25.8%, respectively. The HRs for NAFLD in the longitudinal population were 2.17 (95% CI 1.60–2.93), 3.87 (95% CI 2.89–5.16), 5.81 (95% CI 4.32–7.81) for G2, G3, and G4, respectively. After adjusting for known confounding variables, HRs of G2 to G4 were 1.44 (95% CI 1.06–1.96), 1.94 (95% CI 1.44–2.61), 2.38 (95% CI 1.75–3.23), respectively.This is the first study to demonstrate that increased levels of SBP within the normal range are associated with significantly elevated risks of NAFLD, independent of other confounding factors.

Assessment of the relationship between non‐alcoholic fatty liver disease and diabetic complications

“…In addition, our findings suggest that the NAFLD combined with type 2 diabetes group had the highest level of diastolic blood pressure. The results of Shengjie Wu et al . suggest that increased levels of systolic blood pressure within the normal range are associated with significantly elevated risk for NAFLD.…”

“…In addition, our findings suggest that the NAFLD combined with type 2 diabetes group had the highest level of diastolic blood pressure. The results of Shengjie Wu et al 27 suggest that increased levels of systolic blood pressure within the normal range are associated with significantly elevated risk for NAFLD. Aneni et al 28 reported that controlling blood pressure among non-obese hypertensive patients might be beneficial in preventing or limiting NAFLD.…”

Mean Arterial Pressure Is Related to Incident Nonalcoholic Fatty Liver Disease among the Nonobese Female with Normal Low-Density Lipoprotein Cholesterol Levels: A Large Cohort Study in China

“…Fasting venous blood sample collection (required an overnight fast) would be measured with an automated analyzer (Abbott AxSYM). More specific details were presented in the previous reports [8,11].…”

“…Blood pressure (BP), including systolic blood pressure (SBP) and diastolic blood pressure (DBP), is an important risk factor for developing NAFLD [7][8][9][10], even in individuals without hypertension [10]. Mean arterial pressure (MAP), a steady component of BP, has wildly been used in clinical practice.…”

“…That is to say, NAFLD can increase the risk of developing hypertension, whereas hypertension also increases the risk of developing NAFLD. Meanwhile, research achievements that elevated SBP or DBP which is independently correlated with an increased risk of the incident NAFLD in general population emerge in endlessly recent years [7][8][9][10]. Interestingly, two of the studies indicated elevated blood pressure is associated with incident NAFLD in subjects without hypertension [8,10].…”