Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study
BackgroundIt is unclear whether more severe non–alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertensio...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.942647/full |
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| author | Qi–Rui Song Shuo–Lin Liu Qian-Hui Ling Qian-Nan Gao Rui-Xue Yang Shuo-Hua Chen Shou–Ling Wu Mu-Lei Chen Jun Cai |
| author_facet | Qi–Rui Song Shuo–Lin Liu Qian-Hui Ling Qian-Nan Gao Rui-Xue Yang Shuo-Hua Chen Shou–Ling Wu Mu-Lei Chen Jun Cai |
| author_sort | Qi–Rui Song |
| collection | DOAJ |
| description | BackgroundIt is unclear whether more severe non–alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertension or hypertension.MethodsIn this prospective community–based Kailuan cohort, participants without cardiovascular disease and alcohol abuse, or other liver diseases were enrolled. NAFLD was diagnosed by abdominal ultrasonography. Prehypertension was defined as systolic blood pressure (BP) of 120–139 mmHg or diastolic BP of 80–89 mmHg. Participants with NAFLD were divided into mild, moderate, and severe subgroups. Follow–up for CVEs including myocardial infarction, hemorrhagic stroke, and ischemic stroke. The Cox proportional hazards model was used to estimate hazard ratios and 95% CIs of CVEs according to the severity of NAFLD and hypertensive statutes. The C-statistic was used to evaluate the efficiency of models.ResultsA total of 71926 participants (mean [SD] age, 51.83 [12.72] years, 53794 [74.79%] men, and 18132 [25.21%] women) were enrolled in this study, 6,045 CVEs occurred during a median of 13.02 (0.65) years of follow–up. Compared with participants without NAFLD, the hazard ratios of CVEs for patients with mild, moderate, and severe NAFLD were 1.143 (95% CI 1.071–1.221, P < 0.001), 1.218 (95% CI 1.071–1.221, P < 0.001), and 1.367 (95% CI 1.172–1.595, P < 0.001), respectively. Moreover, participants with prehypertension plus moderate/severe NAFLD and those with hypertension plus moderate/severe NAFLD had 1.558–fold (95% CI 1.293–1.877, P < 0.001) and 2.357–fold (95% CI 2.063–2.691, P < 0.001) higher risks of CVEs, respectively, compared with those with normal BP and no NAFLD. Adding a combination of NAFLD and BP status to the crude Cox model increased the C–statistic by 0.0130 (0.0115–0.0158, P < 0.001).ConclusionsOur findings indicated that the increased cardiovascular risk with elevated BP is largely driven by the coexistence of moderate/severe NAFLD, suggesting that the severity of NAFLD may help further stratify patients with prehypertension and hypertension. |
| first_indexed | 2024-04-13T03:00:59Z |
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| publishDate | 2022-08-01 |
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| spelling | doaj.art-774f594e0acd4b1b9a81e43c9eb05bbf2022-12-22T03:05:26ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.942647942647Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort StudyQi–Rui Song0Shuo–Lin Liu1Qian-Hui Ling2Qian-Nan Gao3Rui-Xue Yang4Shuo-Hua Chen5Shou–Ling Wu6Mu-Lei Chen7Jun Cai8State Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, ChinaState Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaState Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaDepartment of Cardiology, Kailuan General Hospital, Tangshan, ChinaHeart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaState Key Laboratory of Cardiovascular Disease of China, Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundIt is unclear whether more severe non–alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertension or hypertension.MethodsIn this prospective community–based Kailuan cohort, participants without cardiovascular disease and alcohol abuse, or other liver diseases were enrolled. NAFLD was diagnosed by abdominal ultrasonography. Prehypertension was defined as systolic blood pressure (BP) of 120–139 mmHg or diastolic BP of 80–89 mmHg. Participants with NAFLD were divided into mild, moderate, and severe subgroups. Follow–up for CVEs including myocardial infarction, hemorrhagic stroke, and ischemic stroke. The Cox proportional hazards model was used to estimate hazard ratios and 95% CIs of CVEs according to the severity of NAFLD and hypertensive statutes. The C-statistic was used to evaluate the efficiency of models.ResultsA total of 71926 participants (mean [SD] age, 51.83 [12.72] years, 53794 [74.79%] men, and 18132 [25.21%] women) were enrolled in this study, 6,045 CVEs occurred during a median of 13.02 (0.65) years of follow–up. Compared with participants without NAFLD, the hazard ratios of CVEs for patients with mild, moderate, and severe NAFLD were 1.143 (95% CI 1.071–1.221, P < 0.001), 1.218 (95% CI 1.071–1.221, P < 0.001), and 1.367 (95% CI 1.172–1.595, P < 0.001), respectively. Moreover, participants with prehypertension plus moderate/severe NAFLD and those with hypertension plus moderate/severe NAFLD had 1.558–fold (95% CI 1.293–1.877, P < 0.001) and 2.357–fold (95% CI 2.063–2.691, P < 0.001) higher risks of CVEs, respectively, compared with those with normal BP and no NAFLD. Adding a combination of NAFLD and BP status to the crude Cox model increased the C–statistic by 0.0130 (0.0115–0.0158, P < 0.001).ConclusionsOur findings indicated that the increased cardiovascular risk with elevated BP is largely driven by the coexistence of moderate/severe NAFLD, suggesting that the severity of NAFLD may help further stratify patients with prehypertension and hypertension.https://www.frontiersin.org/articles/10.3389/fendo.2022.942647/fullnonalcoholic fatty liver diseaseprehypertensionhypertensioncardiovascular diseaseprognosis |
| spellingShingle | Qi–Rui Song Shuo–Lin Liu Qian-Hui Ling Qian-Nan Gao Rui-Xue Yang Shuo-Hua Chen Shou–Ling Wu Mu-Lei Chen Jun Cai Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study Frontiers in Endocrinology nonalcoholic fatty liver disease prehypertension hypertension cardiovascular disease prognosis |
| title | Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study |
| title_full | Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study |
| title_fullStr | Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study |
| title_full_unstemmed | Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study |
| title_short | Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community–Based Cohort Study |
| title_sort | severity of nonalcoholic fatty liver disease is associated with cardiovascular outcomes in patients with prehypertension or hypertension a community based cohort study |
| topic | nonalcoholic fatty liver disease prehypertension hypertension cardiovascular disease prognosis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.942647/full |
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