Prognostic Significance of Fatty Liver Index for the Development of Hypertension and Cardiovascular Events in Populations With Suboptimal Blood Pressure
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Suboptimal blood pressure (BP) is a precursor to clinical hypertension and is associated with BP-related morbidity and mortality. Non-alcoholic fatty liver disease, a metabolic disorder with an increasing incidence rate, is associated with cardiovascular diseases (CVDs). We investigated the association of fatty liver index (FLI) with incident hypertension and CVD outcomes in a large cohort of adults with suboptimal BP. METHODS: We included 179,028 Koreans with suboptimal BP and no traditional risk factors from the National Health Insurance Service-National Sample Cohort, who underwent health examinations between 2009 and 2014. All subjects were divided into two groups based on their BP: 'normal BP' group (systolic BP [SBP] 120-129, diastolic BP [DBP] 80-84 mmHg), and 'high-normal BP' group (SBP 130-139, DBP 85-89 mmHg). The incidences of new-onset hypertension and major adverse cardiac and cerebrovascular events (MACCEs) were analyzed in the two groups across quartiles. Multivariate Cox proportional hazards regression analysis assessed the association between the FLI and primary outcome. RESULTS: < 0.001). MACCEs were also associated with FLI quartiles. In the multivariable models adjusted for potential confounders, the hazard ratio for MACCEs comparing the highest vs. lowest quartiles of the FLI was 1.640 (95% confidence interval [CI], 1.409-1.910) and 1.363 (95% CI, 1.141-1.627) in the 'high-normal BP' group and 'normal BP' group, respectively. CONCLUSION: Over 8-9 years, 19.3% of Korean adults with suboptimal BP developed hypertension, and 1.87% experienced MACCEs without traditional risk factors. A higher FLI was independently associated with the development of hypertension and MACCEs. The FLI may be an important predictor of new-onset hypertension and adverse cardiovascular outcomes.
Authors: Youngnam Bok, Jae-Hyung Roh, Soo Yeon An, Seon-Ah Jin, Jun Hyung Kim, Hyung Joon Joo, Jung-Woo Son, Sung Hea Kim, Seonghoon Choi, Seongwoo Han, Mi-Seung Shin, Eung Ju Kim, Jin-Ok Jeong, Working Group on Hypertension Complication
Institutions: Chungnam National University, Chungnam National University Hospital, Chungnam National University Sejong Hospital, Korea University Anam Hospital, Yonsei University, Wonju Severance Christian Hospital, Konkuk University, Konkuk University Medical Center, Hallym University Kangnam Sacred Heart Hospital, Hallym University Dongtan Sacred Heart Hospital, Gachon University, Gachon University Gil Medical Center, Korea University Guro Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $690
OpenAlex ID: W4409203210