Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD

Xiao-Dong Zhou¹, Liyou Lian¹, Qin-Fen Chen², Seung Up Kim³, Terry Cheuk-Fung Yip⁴, Salvatore Petta⁵, Atsushi Nakajima⁶, Emmanuel Tsochatzis⁷, Junping Shi⁸, Wah-Kheong Chan⁹, Jérôme Boursier¹⁰, Elisabetta Bugianesi¹¹, Yusuf Yilmaz¹², Hannes Hagström¹³, Manuel Romero-Gomez¹⁴, Khalid Alswat¹⁵, José Luis Calleja¹⁶, Hirokazu Takahashi¹⁷, Victor de Lédinghen¹⁸, Shalimar¹⁹, Laurent Castéra²⁰, Arun J Sanyal²¹, George Boon-Bee Goh²², Philip N Newsome²³, Jian-Gao Fan²⁴, Michelle Lai²⁵, Sandeep Aggarwal²⁶, Stergios Kechagias²⁷, Yoichi Hiasa²⁸, Bheesham Dayal²⁹, Zhongtao Zhang³⁰, Jacob George³¹, Mohamed El-Kassas³², Jinjun Chen³³, Hong You³⁴, Barham K Abu Dayyeh³⁵, Huiping Sheng³⁶, Leon A Adams³⁷, Jing Wang³⁸, Fangping He³⁹, Huiqing Liang⁴⁰, Yong-Feng Yang⁴¹, Xiaoling Chi⁴², Bihui Zhong⁴³, Yan Bi⁴⁴, Yuqiang Mi⁴⁵, Yongfen Zhu⁴⁶, Rixing Bai⁴⁷, Jing Zhang⁴⁸, Bingyuan Wang⁴⁹, Jinghai Song⁵⁰, Hong Deng⁵¹, Qing Xie⁵², Lang Bai⁵³, Yongning Xin⁵⁴, Wen Xie⁵⁵, Jie Li⁵⁶, Céline Fournier-Poizat¹⁸, Mirko Zoncapè⁷, Tianyi Xia⁵⁷, Shenghong Ju⁵⁷, Chutian Wu⁵⁸, Hye Won Lee³, Grace Lai-Hung Wong⁴, Angelo Armandi¹¹, Ying Shang⁵⁹, Grazia Pennisi⁵, Elba Llop¹⁶, Masato Yoneda⁶, Marc de Saint-Loup¹⁰, Clemence M Canivet¹⁰, Carmen Lara-Romero¹⁴, Rocio Gallego-Durán¹⁴, Paloma Carrillo Fernández¹⁴, Amon Asgharpour²¹, Kevin Kim-Jun Teh²², Sara Mahgoub²³, Mandy Sau-Wai Chan¹⁸, Huapeng Lin⁶⁰, Wen-Yue Liu⁶¹, Sherlot Juan Song⁴, Waleed K Al-Hamoudi¹⁵, Hiroshi Isoda⁶², Teruki Miyake²⁸, Sanjaya K Satapathy²⁹, Mengyi Li³⁰, Keshni Sharma³¹, Mohammed Emadeldeen⁶³, Ling Zhou³³, Xiaofei Tong³⁴, Fateh Bazerbachi³⁵, Xiaotang Fan³⁹, Huanming Xiao⁴², Junzhao Ye⁴³, Liang Xu⁴⁵, Xiaolin Wang⁵², Giovanni Targher⁶⁴, Christopher D Byrne⁶⁵, Michael D Shapiro⁶⁶, Frank Tacke⁶⁷, Vincent Wai-Sun Wong⁶⁸, Ming-Hua Zheng⁶⁹; VCTE-Prognosis Study Group and Paired Liver Biopsy Consortium

Affiliations

¹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, 32500, China.
³ Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Section of Gastroenterology, PROMISE, University of Palermo, Italy.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.
⁸ Department of Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou, China.
⁹ Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia.
¹⁰ Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
¹¹ Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
¹² Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
¹³ Department of Medicine, Huddinge, Karolinska Institutet, Sweden; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
¹⁴ Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain.
¹⁵ Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
¹⁶ Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
¹⁷ Liver Center, Saga University Hospital, Saga, Japan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
¹⁸ Echosens, Paris, France.
¹⁹ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Delhi, India.
²⁰ Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France.
²¹ Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
²² Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
²³ Institute of Hepatology, Faculty of Life Sciences & Medicine, King's College London and King's College Hospital, London, UK.
²⁴ Department of Gastroenterology and Hepatology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
²⁵ Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
²⁶ Institute of Minimal Access, Bariatric, GI and Robotic Surgery, Manipal Hospitals, Dwarka, New Delhi, India.
²⁷ Department of Health, Medicine and Caring Sciences, Linköping University, Sweden Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden.
²⁸ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
²⁹ Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, NY, USA; Northwell Health Center for Liver Diseases & Transplantation, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead Tpke, Hempstead, NY, USA.
³⁰ 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.
³¹ Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
³² Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt.
³³ Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Department of Hepatology, Zengcheng Branch, China State Key Laboratory of Organ Failure Research Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
³⁴ 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.
³⁵ Division of Gastroenterology and Hepatology, Cedar Sinai Medical Center, Los Angeles, CA.
³⁶ Department of Infectious Diseases, General Hospital of Ningxia Medical University, Ningxia, China.
³⁷ Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
³⁸ Department of Hepatobiliary Disease, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
³⁹ Department of Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
⁴⁰ Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China.
⁴¹ Department of Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
⁴² Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
⁴³ Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁴⁴ Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁴⁵ Department of Hepatology, Clinical School of the Second People's Hospital, Tianjin Institute of Hepatology, Tianjin Medical University, Tianjin, China.
⁴⁶ Department of Hepatology and Infection, Sir Run Run Shaw Hospital, Affiliated with School of Medicine, Zhejiang University, Hangzhou, China.
⁴⁷ Department of General Surgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
⁴⁸ Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
⁴⁹ Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China.
⁵⁰ Department of General Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
⁵¹ Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵² Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵³ Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁵⁴ Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
⁵⁵ Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
⁵⁶ Department of Infectious Disease, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁵⁷ 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, 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China.
⁵⁸ Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangdong, China.
⁵⁹ Department of Medicine, Huddinge, Karolinska Institutet, Sweden.
⁶⁰ 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.
⁶¹ Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁶² Liver Center, Saga University Hospital, Saga, Japan.
⁶³ Gastroenterology and Hepatology Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
⁶⁴ Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy.
⁶⁵ Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK.
⁶⁶ Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, USA.
⁶⁷ Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Berlin, Germany.
⁶⁸ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wongv@cuhk.edu.hk.
⁶⁹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; 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. Electronic address: zhengmh@wmu.edu.cn.

PMID: 40854336
DOI: 10.1016/j.jhep.2025.08.017

Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD

Xiao-Dong Zhou et al. J Hepatol. 2025.

. 2025 Aug 23:S0168-8278(25)02453-5.

doi: 10.1016/j.jhep.2025.08.017. Online ahead of print.

Authors

Affiliations

¹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, 32500, China.
³ Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Section of Gastroenterology, PROMISE, University of Palermo, Italy.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.
⁸ Department of Hepatology, Hangzhou Normal University Affiliated Hospital, Hangzhou, China.
⁹ Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia.
¹⁰ Hepato-Gastroenterology and Digestive Oncology Department, Angers University Hospital, Angers, France.
¹¹ Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
¹² Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
¹³ Department of Medicine, Huddinge, Karolinska Institutet, Sweden; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.
¹⁴ Digestive Diseases Unit and CIBERehd, Virgen Del Rocío University Hospital, Seville, Spain.
¹⁵ Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
¹⁶ Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
¹⁷ Liver Center, Saga University Hospital, Saga, Japan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
¹⁸ Echosens, Paris, France.
¹⁹ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Delhi, India.
²⁰ Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France.
²¹ Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
²² Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
²³ Institute of Hepatology, Faculty of Life Sciences & Medicine, King's College London and King's College Hospital, London, UK.
²⁴ Department of Gastroenterology and Hepatology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
²⁵ Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
²⁶ Institute of Minimal Access, Bariatric, GI and Robotic Surgery, Manipal Hospitals, Dwarka, New Delhi, India.
²⁷ Department of Health, Medicine and Caring Sciences, Linköping University, Sweden Department of Gastroenterology and Hepatology, University Hospital, Linköping, Sweden.
²⁸ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
²⁹ Department of Medicine, North Shore University Hospital/Northwell Health, Manhasset, NY, USA; Northwell Health Center for Liver Diseases & Transplantation, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra, Hempstead Tpke, Hempstead, NY, USA.
³⁰ 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.
³¹ Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
³² Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt; Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt.
³³ Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Department of Hepatology, Zengcheng Branch, China State Key Laboratory of Organ Failure Research Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
³⁴ 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.
³⁵ Division of Gastroenterology and Hepatology, Cedar Sinai Medical Center, Los Angeles, CA.
³⁶ Department of Infectious Diseases, General Hospital of Ningxia Medical University, Ningxia, China.
³⁷ Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
³⁸ Department of Hepatobiliary Disease, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
³⁹ Department of Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
⁴⁰ Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China.
⁴¹ Department of Liver Disease, the Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
⁴² Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
⁴³ Department of Gastroenterology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁴⁴ Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁴⁵ Department of Hepatology, Clinical School of the Second People's Hospital, Tianjin Institute of Hepatology, Tianjin Medical University, Tianjin, China.
⁴⁶ Department of Hepatology and Infection, Sir Run Run Shaw Hospital, Affiliated with School of Medicine, Zhejiang University, Hangzhou, China.
⁴⁷ Department of General Surgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China.
⁴⁸ Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
⁴⁹ Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China.
⁵⁰ Department of General Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
⁵¹ Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
⁵² Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵³ Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
⁵⁴ Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
⁵⁵ Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
⁵⁶ Department of Infectious Disease, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
⁵⁷ 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, 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China.
⁵⁸ Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangdong, China.
⁵⁹ Department of Medicine, Huddinge, Karolinska Institutet, Sweden.
⁶⁰ 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.
⁶¹ Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁶² Liver Center, Saga University Hospital, Saga, Japan.
⁶³ Gastroenterology and Hepatology Department, National Hepatology & Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
⁶⁴ Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy.
⁶⁵ Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK.
⁶⁶ Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, USA.
⁶⁷ Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Berlin, Germany.
⁶⁸ Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wongv@cuhk.edu.hk.
⁶⁹ MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; 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. Electronic address: zhengmh@wmu.edu.cn.

PMID: 40854336
DOI: 10.1016/j.jhep.2025.08.017

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 and risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD.

Methods: Three multicenter prospective 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 (LSM) from <10 kPa to ≥10 kPa or an increase of ≥20% for baseline LSM ≥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 the outcomes.

Results: 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. Hypertension rates were 37.1%, 33.4%, and 48.9%, respectively. In the UKBB cohort, hypertension was associated with long-term adverse clinical outcomes (adjusted 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 and increases risk of adverse clinical outcomes and progression of liver stiffness/fibrosis.

Keywords: cardiometabolic risk; hepatic steatosis; liver histology; prognosis; transient elastography.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest Dr. Seung Up Kim reported personal fees from Gilead Sciences, GSK, Bayer, Eisai, AbbVie, Echosens, MSD, Bristol-Myers Squibb, and AstraZeneca outside the submitted work, and grants from AbbVie, Bristol-Myers Squibb, and Gilead Sciences outside the submitted work. Dr. Terry Cheuk-Fung Yip reported serving as an advisory committee member and a speaker for Gilead Sciences outside the submitted work. Dr. Atsushi Nakajima reported receiving honoraria for Mochida Pharmaceutical, Kowa, Biofermin, MSD, Behringer Ingelheim, Novo Nordisk, GSK, EA pharma, Taiho, and Tsumura, grants for Gilead Sciences, Mochida Pharmaceuticals, Kowa, Astellas Pharma, ASKA pharmaceutical, Biofermin, and EA pharma. Dr. Emmanuel Tsochatzis reported receiving personal fees as an advisory board member for Boehringer, Novo Nordisk, Pfizer, and Siemens; receiving speaker fees from Echosens, Novo Nordisk, and AbbVie outside the submitted work. Dr. Wah-Kheong Chan reported serving as a consultant or advisory board member for Zuellig Pharma, Abbott, Roche, AbbVie, Boehringer Ingelheim, and Novo Nordisk; and a speaker for Novo Nordisk, Abbott, Echosens, Viatris, and Hisky Medical. Dr. Jérôme Boursier reported receiving grants and personal fees from Echosens outside the submitted work. Dr. Yusuf Yilmaz received personal consultancy fees from Novo Nordisk and Zydus. Dr. Hannes Hagström reported personal fees from AstraZeneca, Bristol Myers-Squibb, MSD, Novo Nordisk, Boehringer Ingelheim, KOWA, and GW Phara outside the submitted work, and grants from AstraZeneca, Echosens, Gilead Sciences, Intercept, MSD, Novo Nordisk, and Pfizer outside the submitted work. Dr. Manuel Romero-Gomez reported receiving personal fees from Echosens outside the submitted work. Dr. José Luis Calleja reported receiving other support from Echosens Clinical Trials during the conduct of the study; grants from Roche Pharma and other support from Gilead Advisory Board outside the submitted work. Dr. Victor de Lédinghen reported receiving nonfinancial support from Echosens during the conduct of the study. Dr. Laurent Castéra reported receiving personal fees for consulting and speakers bureau from Echosens during the conduct of the study; personal consultancy fees from Boston pharmaceutical and Gilead, speaker bureau and consultancy personal fees from GSK, personal speaker bureau fees from Inventiva, personal consultancy fees from Madrigal, MSD, Novo Nordisk, Pfizer, Sagimet, and Siemens Healthineers outside the submitted work. Dr. Arun J. Sanyal reported receiving grants from Intercept, personal consulting fees from Gilead, grants from Merck, personal consulting fees from Pfizer, grants and personal consulting fees from Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Novartis, Histoindex, and stock options from Genfit, Tiziana, Durect, Inversago, and personal consulting fees from Genentech, ALnylam, Regeneron, Zydus, LG chem, Hanmi, Madrigal, Path AI, 89 Bio, and stock options from Galmed outside the submitted work. Dr. George Boon-Bee Goh served as a consultant or advisory board member for Boehringer Ingelheim, Novo Nordisk, MSD, and Roche Diagnostics; and a speaker for Abbott, Novo Nordisk, and Echosens. Dr. Philip N Newsome reported receiving grants from Novo Nordisk, advisory board and personal consulting fees, honoraria for lectures and travel expenses from Novo Nordisk, personal consulting and advisory board fees from Boehringer Ingelheim, Gilead, Intercept, Poxel Pharmaceuticals, Bristol-Myers Squibb, Pfizer, MSD, Sun Pharma, Eli Lilly, Madrigal, GSK, and nonfinancial support for educational events from AiCME outside the submitted work. Dr. Leon A. Adams has received personal speaker fees from Novo Nordisk, CSL Behring, and has been on Advisory boards for Novo Nordisk. Dr. Masato Yoneda reported receiving honoraria for Kowa, and grants from Gilead Sciences. Dr. Céline Fournier reported being in full-time employment at Echosens during the conduct of the study. Dr. Grace Lai-Hung Wong reported receiving personal fees from Echosens during the conduct of the study; and grants from Gilead Sciences Research outside the submitted work. Dr. Mandy Sau-Wai Chan reported being employed full-time by Echosens during the conduct of the study. Dr. Frank Tacke’s lab has received research funding (to the institution) from AstraZeneca, MSD, Gilead, and Agomab. Dr. Frank Tacke has received honoraria for consulting or lectures from AstraZeneca, Abbvie, Alnylam, Boehringer, Falk, MSD, GSK, Pfizer, Novo Nordisk, and Sanofi. Dr. Vincent Wai-Sun Wong reported receiving personal speaker fees from Abbott, consultant and speaker fees from AbbVie, personal consultant fees from Boehringer Ingelheim, Echosens, Gilead Sciences, grants from Gilead Sciences, personal consultant fees from Intercept, Inventiva, Novo Nordisk, Pfizer, Sagimet Biosciences, TARGET PharmaSolutions, personal speaker fees from Unilab, personal consultant fees from Visirna, and being a cofounder of Illuminatio outside the submitted work. Ming-Hua Zheng: Serves as a speaker for AstraZeneca, Hisky Medical Technologies, and Novo Nordisk; as a consultant for Boehringer Ingelheim and Eieling Technology; and has received consulting fees from Boehringer Ingelheim. No other disclosures were reported.

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD

Affiliations

Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD

Authors

Affiliations

Abstract

Conflict of interest statement

LinkOut - more resources

Full Text Sources