Work

Blood Pressure Trajectories in Young Adulthood and Midlife Steatotic Liver Disease

Year: 2026

Type: article

Abstract: BACKGROUND: Although high blood pressure (BP) is a risk factor for steatotic liver disease (SLD), whether longitudinal BP trajectories starting in young adulthood are associated with midlife SLD is unclear. METHODS: We used data from a US-based prospective cohort, the CARDIA study (Coronary Artery Risk Development in Young Adults), which enrolled 5115 Black and White adults aged 18 to 30 years in 1985 to 1986 (Year 0, Y0). Diastolic and systolic BP and hypertension trajectories were evaluated based on up to 8 BP measures over a 25-year follow-up. SLD at Y25 was measured using noncontrast abdominal computed tomography scans. RESULTS: Among 2817 participants included in the analytic sample, 622 SLD cases were identified. Compared with the low-stable diastolic BP group, other trajectories showed higher SLD prevalence (22.0%-37.5% versus 12.8%), with multivariable-adjusted relative risks of 1.47 (95% CI, 1.17-1.84) for moderate-stable, 1.77 (1.33-2.35) for moderate-increasing (remaining below the threshold for hypertension), 1.57 (1.21-2.04) for elevated-stable, and 2.02 (1.41-2.88) for the elevated-increasing trajectory. Similar positive associations were observed for systolic BP trajectories. Compared with those persistently normotensive, participants who developed hypertension had significantly higher SLD risks: 1.62-fold for late-onset and 1.75-fold for both mid-adulthood and early onset. Consistently, a faster rate of BP increase was linked to higher SLD risk. CONCLUSIONS: Long-term BP and hypertension patterns in young adulthood were independently associated with increased midlife SLD risk, with rapidly increasing BP exhibiting the greatest risk. Long-term BP changes may assist in more accurate identification of individuals at higher risk of SLD.

Source: Hypertension

DOI: 10.1161/hypertensionaha.125.26319