European Journal of Gastroenterology & Hepatology. 30(9):979–985, SEP 2018
DOI: 10.1097/MEG.0000000000001191
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PMID: 30048367
Issn Print: 0954-691X
Publication Date: 2018/09/01
Non-alcoholic fatty liver disease and hypertension: coprevalent or correlated?
Dimitrios Oikonomou;Georgios Georgiopoulos;Vassiliki Katsi;Chris Kourek;Constantinos Tsioufis;Alexendra Alexopoulou;Evaggelia Koutli;Dimitrios Tousoulis;
+ Author Information
aDepartment of Cardiology, ‘Evaggelismos’ General Hospital of AthensbFirst Department of CardiologycDepartment of Internal Medicine, ‘Hippokration’ Hospital, University of Athens, Medical School, Athens, Greece
Abstract
To provide a comprehensive review summarizing the existing evidence on the association between nonalcoholic fatty liver disease (NAFLD) and hypertension (HT) independent of other components of metabolic syndrome.We searched the literature through Medline and the Cochrane Library for studies evaluating the relationship between hypertension and fatty liver disease.Studies testing this association are limited, but agree that HT and fatty liver disease are inter-related independent of other components of the metabolic syndrome such as obesity and diabetes mellitus. Clinical evidence shows that NAFLD is associated with new-onset HT, whereas increased blood pressure is related to the development of fatty liver disease and the possible subsequent progression to liver fibrosis. Insulin resistance and activation of the renin–angiotensin–aldosterone system (RAAS) might provide potential pathophysiologic links between these clinical entities. Until further evidence is available, patients with HT should be meticulously evaluated and treated for fatty liver disease and vice versa. RAAS inhibitors have been tested in NAFLD, presenting a favorable profile by decreasing insulin resistance and fibrosis progression.NAFLD and HT are associated independent of traditional cardiovascular risk factors. Insulin resistance appears to be the main linking mechanism. Although RAAS inhibitors are the most beneficial treatment option for HT in patients with NAFLD, randomized studies on the administration of these agents in HT patients with NAFDL are warranted to provide optimal treatment options in these high cardiovascular risk individuals.
