Please use this identifier to cite or link to this item:
https://wslhd.intersearch.com.au/wslhdjspui/handle/1/16436| Title: | Effect of hypertension on long-term adverse clinical outcomes and liver fibrosis progression in MASLD |
| Authors: | Zhou, X. D.;Lian, L. Y.;Chen, Q. F.;Yip, T. C. F.;Cast�ra, L.;Sanyal, A. J.;Fan, J. G.;Lai, M.;Dayal, B.;Chen, J.;Adams, L. A.;Fournier-Poizat, C.;Zoncap�, M.;Xia, T.;Ju, S.;Lee, H. W.;Wong, G. L. H.;Armandi, A.;Shang, Y.;Pennisi, G.;Llop, E.;Yoneda, M.;de Saint-Loup, M.;Canivet, C. M.;Lara-Romero, C.;Gallego-Dur�n, R.;Carrillo-Fern�ndez, P.;Asgharpour, A.;Teh, K. K. J.;Mahgoub, S.;Chan, M. S. W.;Lin, H.;Liu, W. Y.;Song, S. J.;Al-Hamoudi, W. K.;Isoda, H.;Miyake, T.;Satapathy, S. K.;Li, M.;Sharma, Keshni;Emadeldeen, M.;Zhou, L.;Tong, X.;Bazerbachi, F.;Fan, X.;Xiao, H.;Ye, J.;Xu, L.;Wang, X.;Targher, G.;Byrne, C. D.;Shapiro, M. D.;Tacke, F.;Wong, V. W. S.;Zheng, M. H.;Nakajima, A.;Bugianesi, E.;Tsochatzis, E.;Goh, G. B. B.;Hagstr�m, H.;Boursier, J.;Calleja, J. L.;Romero-Gomez, M.;Newsome, P. N.;Kim, S. U.;de L�dinghen, V.;Abu Dayyeh, B. K.;Zhong, B.;Wang, B.;Wu, C.;He, F.;Takahashi, H.;Deng, H.;You, H.;Sheng, H.;Liang, H.;George, Jacob;Li, J.;Wang, J.;Zhang, J.;Song, J.;Shi, J.;Alswat, K.;Bai, L.;Adams, L. A.;El-Kassas, M.;Xie, Q.;Bai, R.;Petta, S.;Aggarwal, S.;Kechagias, S.;Wong, V.;Chan, W. K.;Xie, W.;Chi, X.;Bi, Y.;Hiasa, Y.;Zhu, Y.;Yang, Y. F.;Xin, Y.;Mi, Y.;Yilmaz, Y.;Zhang, Z. |
| WSLHD Author: | Sharma, Keshni;George, Jacob |
| Subjects: | Hepatology;Cardiology |
| Issue Date: | 2026 |
| Citation: | Journal of Hepatology. 84(2):254-265, 2026 Feb |
| Abstract: | BACKGROUND & AIMS: Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension with the risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD. METHODS: Three multicenter large cohorts were analyzed: the UK Biobank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression. Adverse clinical outcomes were defined as all-cause mortality, cardiovascular events, and/or liver-related events. Liver stiffness progression was defined as an increase in liver stiffness measurement from <10 kPa to ?10 kPa or an increase of ?20% for baseline liver stiffness measurement ?10 kPa. Liver fibrosis progression was defined as a 1-stage fibrosis stage increase. Cox regression and Kaplan-Meier analyses were used to evaluate the impact of baseline hypertension on outcomes. RESULTS: A total of 107,316 adults from the UKBB cohort, 8,169 from the VCTE-Prognosis cohort, and 1,670 from the Paired Liver Biopsy cohort were included. The prevalence of hypertension was 37.1%, 33.4%, and 48.9%, respectively. In the UKBB cohort, hypertension was associated with long-term adverse clinical outcomes (adjusted hazard ratio [HR] 1.30, 95% CI 1.26-1.33, p <0.001). In the VCTE-Prognosis cohort, hypertension was associated with a higher risk of liver stiffness progression (adjusted HR 1.57, 95% CI 1.30-1.90, p <0.001), while in the Paired Liver Biopsy cohort, hypertension was associated with a greater risk of histologic liver fibrosis progression (adjusted HR 1.41, 95% CI 1.12-1.78, p = 0.004). Subgroup and sensitivity analyses supported these findings. CONCLUSIONS: Hypertension is a modifiable risk factor that increases the risk of adverse clinical outcomes and progression of liver stiffness and fibrosis in MASLD. Impact and implications: This study provides robust evidence from three large multicenter cohorts demonstrating that hypertension is independently associated with increased risks of adverse clinical outcomes and liver fibrosis progression in individuals with MASLD. These findings reveal that hypertension, traditionally managed from a cardiovascular perspective, also plays a critical and underrecognized role in liver disease progression, making them highly relevant for hepatologists, cardiologists, and primary care providers. Incorporating non-invasive fibrosis assessments into routine care for patients with MASLD and hypertension may facilitate early risk stratification and support targeted interventions to reduce both hepatic and cardiovascular complications. |
| URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/16436 |
| DOI: | https://doi.org/10.1016/j.jhep.2025.08.017 |
| Journal: | Journal of Hepatology |
| Type: | Journal Article |
| Study or Trial: | Cohort Analysis Controlled Study Major Clinical Study Multicentre Study Retrospective Study Sensitivity Analysis |
| Department: | Gastroenterology & Hepatology Allied Health |
| Facility: | Blacktown Westmead |
| Affiliated Organisations: | MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Institute of Aging, Wenzhou Medical University, Wenzhou, China Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong Section of Gastroenterology, PROMISE, University of Palermo, Italy Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom Department of Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou, China Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Citt� della Salute e della Scienza di Torino, University of Turin, Turin, Italy Department of Gastroenterology, School of Medicine, Recep Tayyip Erdo?an University, Rize, Turkey Department of Medicine, Karolinska Institute, Huddinge, Sweden Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden UCM Digestive Diseases, Virgen del Roc�o University Hospital, Centro de Investigaci�n Biom�dica en Red en Enfermedades Hep�ticas y Digestivas (CIBEREHD), Institute of Biomedicine of Seville (IBiS), University of Seville, Spain Liver Disease Research Center, Department of Medicine, College of Medicine, King Saudi University, Riyadh, Saudi Arabia Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain Liver Center, Saga University Hospital, Saga, Japan Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan Echosens, Paris, France Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India Universit� Paris Cit�, UMR1149 (CRI), INSERM, Paris, France Service d'H�patologie, H�pital Beaujon, Assistance Publique-H�pitaux de Paris (AP-HP), Clichy, France Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, United States Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore Institute of Hepatology, Faculty of Life Sciences & Medicine, King�s College London and King�s College Hospital, London, United Kingdom Department of Gastroenterology and Hepatology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Institute of Minimal Access, Bariatric, GI and Robotic Surgery, Manipal Hospitals, New Delhi, Dwarka, India Department of Health, Medicine and Caring Sciences, Link�ping University, Link�ping, Sweden Department of Gastroenterology and Hepatology, University Hospital, Link�ping, Sweden Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, NY, United States Northwell Health Center for Liver Diseases & Transplantation, Manhasset, NY, United States Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead Tpke, Hempstead, NY, United States Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases & State Key Lab of Digestive Health, Beijing, China Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt Applied Science Research Center, Applied Science Private University, Amman, Jordan Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China Department of Hepatology, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China State Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangzhou, China Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China Liver Research Center, Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center of Digestive Diseases, Capital Medical University, Beijing, China Division of Gastroenterology and Hepatology, Cedar Sinai Medical Center, Los Angeles, CA, United States Department of Infectious Diseases, General Hospital of Ningxia Medical University, Ningxia, China Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia Medical School, The University of Western Australia, Perth, Australia Department of Hepatobiliary Disease, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China Department of Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China Department of Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China Department of Hepatology, Clinical School of the Second People's Hospital, Tianjin Institute of Hepatology, Tianjin Medical University, Tianjin, China Zhejiang Key Laboratory of Multi-omics Precision Diagnosis and Treatment of Liver Diseases, Department of Liver and Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China Department of General Surgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China Department of General Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China Department of Infectious Disease, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangdong, China Department of Gastroenterology and Hepatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China Center for Digestive Diseases Research and Clinical Translation of Shanghai Jiao Tong University, Shanghai, China Shanghai Key Laboratory of Gut Microecology and Associated Major Diseases Research, Shanghai, China Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Gastroenterology and Hepatology Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt Department of Medicine, University of Verona, Verona, Italy Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, United Kingdom Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, United States Department of Hepatology and Gastroenterology, Charit� - Universit�tsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charit� Mitte (CCM), Berlin, Germany Institute of Hepatology, Wenzhou Medical University, Wenzhou, China Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China Virginia Commonwealth University, United States University of Yokohama, Japan University of Torino, Italy Royal Free Hospital, United Kingdom Singapore General Hospital, Singapore Karolinska University Hospital, Sweden Angers University Hospital, France Hospital Puerta de Hierro, Spain University of Seville, Spain Wenzhou Medical University, China University of Birmingham, United Kingdom University of Palermo, Italy Yonsei University School of Medicine, South Korea University of Bordeaux, France The Chinese University of Hong Kong, China University of Malaya, Malaysia University of Minnesota, United States North Shore University Hospital, United States Sun Yat-sen University, China China Medical University, China Guangzhou Medical University, China Xinjiang Medical University, China Saga University, Japan Capital Medical University, China Ningxia Medical University, China Xiamen Hospital of Traditional Chinese Medicine, China University of Sydney, Australia Nanjing University Medical School, China Southwest Medical University, China Beijing Hospital, China Southern Medical University, China Hangzhou Normal University, China King Saud University, Saudi Arabia Sichuan University, China The University of Western Australia, Australia Helwan University, Egypt Shanghai Jiao Tong University, China Universit� di Palermo, Italy All India Institute of Medical Sciences, India Link�ping University, Sweden Guangzhou University of Chinese Medicine, China Ehime University Graduate School, Japan Zhejiang University, China Nanjing University of Chinese Medicine, China Qingdao University, China Tianjin Medical University, China Recep Tayyip Erdogan University, Turkey Beijing Friendship Hospital, China |
| Keywords: | cardiometabolic risk hepatic steatosis liver histology prognosis transient elastography |
| Appears in Collections: | WSLHD publications |
Files in This Item:
There are no files associated with this item.
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.