Key result
Patients with NASH had a 46.7% prevalence of arterial hypertension (30% previously undetected) compared with 37.6% in NAFLD and 31.1% in chronic HCV controls.
Why the study?
NAFLD and NASH progression is linked to insulin resistance and the metabolic syndrome, including hypertension, which carries cardiovascular risk. This study aimed to determine the prevalence of arterial hypertension in patients with liver disease and the rate of undetected hypertension in patients with NAFLD and NASH.
Observational (n=168)
No
Answers are grounded in this paper and cite their sources.
Observational study reveals high rates of undetected arterial hypertension in non-alcoholic steatohepatitis, highlighting the need for routine blood pressure screening.
Background and Aims: Non-alcoholic fatty liver disease (NAFLD) is an emerging disorder characterized by fatty infiltration of the liver in the absence of alcohol consumption. NAFLD ranges from simple steatosis to NASH, which might progress to end-stage liver disease. This progression is related to insulin resistance, which is strongly linked to the metabolic syndrome consisting of central obesity, dyslipidemia, and hypertension. Each of these abnormalities carries a risk for cardiovascular disease. The aim of this study was to determine the prevalence of arterial hypertension in patients with liver disease and to identify the rate of undetected hypertension in patients with NAFLD and NASH. Methods: Patient records from 2006 to 2008 of the in- and outpatient department of the Department of Gastroenterology and Hepatology of the University Hospital of Cologne with biopsy proven NAFLD (n=16) or NASH (n = 30) were retrospectively reviewed for the prevalence of arterial hypertension (blood pressure >140/90 mmHg). Patients with a history of hypertension or concomitant therapy with blood pressure lowering agents were categorized as known hypertensives. Patients with chronic hepatitis C virus infection served as a control group (n = 122). Results: The number of known hypertensives was 13/122 (10.7%) in the HCV group, 3/16 (18.7%) in the NAFLD group and 5/30 (16.7%) in the NASH group. The number of previously undetected hypertensives was 25/122 (20.5%) in the HCV group, 3/16 (18.8%) in the NAFLD group and 9/30 (30%) in the NASH group. Thus, the prevalence of arterial hypertension was 31.1% in the HCV group, 37.6% in the NAFLD group and 46.7% in the NASH group. Conclusion: We observed a high rate of undetected and untreated arterial hypertension in patients with liver disease, especially NASH. Since the incidence of NAFLD/NASH is expected to rise in Western countries gastroenterologists and hepatologists should be encouraged to take the opportunity to measure blood pressure routinely and attend to an adjustment of antihypertensive therapy during specialized care for this high risk population.
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Steffen et al. (2010) conducted an observational in Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) (n=168). Non-alcoholic steatohepatitis (NASH) and NAFLD vs. Chronic hepatitis C virus (HCV) infection was evaluated on Prevalence of arterial hypertension (blood pressure >140/90 mmHg or history/treatment of hypertension). Patients with NASH had a 46.7% prevalence of arterial hypertension (30% previously undetected) compared with 37.6% in NAFLD and 31.1% in chronic HCV controls.
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