The relationship between liver enzymes, prehypertension and hypertension in the Azar cohort population

Abstract Background The incidence of hypertension (HTN) as a worldwide health problem is rising rapidly. Early identification and management of pre-HTN before HTN development can help reduce its related complications. We evaluated the relationship between liver enzymes levels and pre-HTN/HTN in the Azar cohort population. Method This cross-sectional study was based on data from the large Azar cohort study and a total of 14,184 participants were included. Pre-HTN and HTN were defined based on the American Heart Association guideline. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) levels were measured by Pars Azmoon kits. The relationship between pre-HTN/HTN and liver enzyme levels was evaluated by logistic regression. Results Of 14,184 participants, 5.7% and 39.6% had pre-HTN and HTN, respectively. In the adjusted model, AST levels of 19–23 IU/l were associated with an elevated risk of pre-HTN (OR 95% CI: 1.24 1.04–1.48). A dose-response increase was seen in pre-HTN in relation to ALT, with the highest OR in the third tertile (1.34 1.09–1.63). The odds of pre-HTN also increased with GGT in the third tertile (1.251.03–1.52). In addition, the odds of HTN increased with increased levels of AST, ALT, ALP, and GGT, such that the highest ORs were recorded in the third tertile (OR 1.22 1.09–1.37, 1.51 1.35–1.70, 1.19 1.07–1.34, and 1.68 1.49–1.89, respectively). Among these enzymes, GGT had the highest OR regarding HTN. Conclusion This study indicates that AST, ALT, ALP and GGT levels were associated with pre-HTN (except for ALP) and HTN, independent of known risk factors. Hence, it may be possible to use liver enzymes to predict the incidence of pre-HTN and HTN, empowering primary care providers to make the necessary interventions promptly.