Hypertension ups risks of adverse outcomes, fibrosis progression in MASLD

Patients with metabolic dysfunction-associated steatotic liver disease (MASLD), who also happen to have hypertension, are at much greater risk of adverse clinical outcomes and progression of liver stiffness and fibrosis, according to a study.

The authors analysed three multicentre cohorts: the UK Biobank (n=107,316) to assess the risk of adverse clinical outcomes, the VCTE-Prognosis (n=8,169) to assess liver stiffness and fibrosis progression, and the Paired Liver Biopsy cohorts (n=1,670) to assess histologic liver fibrosis progression. The impact of baseline hypertension on outcomes was examined using Cox regression and Kaplan-Meier analyses.

Adverse clinical outcomes referred to all-cause mortality, cardiovascular events, and/or liver-related events. Liver stiffness progression was defined by an increase in liver stiffness measurement from <10 to ≥10 kPa or ≥20-percent increase from baseline liver stiffness measurement ≥10 kPa. Finally, liver fibrosis progression was characterized by a 1-level increase in fibrosis stage.

Hypertension prevalence was 37.1 percent in the UK Biobank, 33.4 percent in the VCTE-Prognosis, and 48.9 percent in the Paired Liver Biopsy cohorts.

In the first cohort, hypertension significantly correlated with long-term adverse clinical outcomes (adjusted hazard ratio [aHR], 1.30, 95 percent confidence interval [CI], 1.26‒1.33; p<0.001).

Likewise, hypertension showed a significant association with an increased risk of liver stiffness progression (aHR, 1.57, 95 percent CI, 1.30‒1.90; p<0.001) in the VCTE-Prognosis cohort and with an elevated risk of histologic liver fibrosis progression (aHR, 1.41, 95 percent CI, 1.12‒1.78; p=0.004) in the Paired Liver Biopsy cohort.

These findings were consistent in subgroup and sensitivity analyses.