Key result
Elevated serum alanine aminotransferase (>40 U/L) was associated with a 55% increased odds of hypertension (OR 1.55) compared to normal levels in a national cohort of over 21 million Chinese adults.
Why the study?
Inconsistent results were found in the association between serum alanine aminotransferase and hypertension among population-based studies.
Does elevated serum ALT increase the odds of hypertension in Chinese reproductive-age adults?
Cross-Sectional (n=21,103,790)
Yes
Does elevated serum ALT increase the odds of hypertension in Chinese reproductive-age adults?
Odds Ratio: 1.55 (95% CI 1.54–1.56)
Absolute Event Rate: 8.56% vs 3.63%
p-value: p=<0.001
Elevated serum ALT is linearly associated with higher odds of hypertension and increased blood pressure in Chinese reproductive-age adults, suggesting a link between abnormal liver metabolism and blood pressure regulation.
ALT elevation was associated with higher hypertension odds in reproductive-age Chinese adults; leaves open causality and practice implications pending prospective data.
Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.
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Jia et al. (2021) conducted a cross-sectional in Hypertension (n=21,103,790). Elevated serum alanine aminotransferase (ALT) vs. Normal ALT (≤ 40 U/L) was evaluated on Hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) (OR 1.55, 95% CI 1.54-1.56, p=<0.001). Elevated serum alanine aminotransferase (>40 U/L) was associated with a 55% increased odds of hypertension (OR 1.55) compared to normal levels in a national cohort of over 21 million Chinese adults.
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