title: Nonalcoholic fatty liver disease is associated with blood pressure in hypertensive and nonhypertensive individuals from the general population with normal levels of alanine aminotransferase.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) has been associated with hypertension in specific population groups and in cases with elevated levels of alanine aminotransferase (ALT). This study aimed to determine the strength of the association between NAFLD with prevalent hypertension and with high-normal blood pressure (BP) in nonhypertensive individuals from the general population regardless of ALT levels.
  
  
  METHODS
  The observational study included 454 participants selected randomly from the general population aged 50-75 years old. Adjusted odds ratios and 95% confidence intervals (CIs) of NAFLD with hypertension were calculated by binary multivariate regression analysis controlling for traditional risk factors and ALT levels. Similar calculations were performed to assess the independent association of NAFLD with high-normal systolic (130-139 mmHg) and diastolic (85-89 mmHg) BP in the subgroup of nonhypertensive participants.
  
  
  RESULTS
  The prevalence of NAFLD was 38.5% (95% CI, 34.0-43.0) in the entire sample and 49.5% (95% CI, 44.9-54.1) in hypertensive participants. The percentage of cases with hypertension was 21.2% greater in individuals with NAFLD than those without NAFLD (95% CI, 11.8-30.6, P<0.0005). NAFLD was independently associated with prevalent hypertension with an adjusted odds ratio of 1.71 (95% CI, 1.10-2.65, P=0.017). Among nonhypertensive participants, NAFLD was also independently associated with high-normal systolic BP (adjusted odds ratio 2.13, 95% CI, 1.08-4.20, P=0.029) but not with high-normal diastolic BP.
  
  
  CONCLUSIONS
  In middle-aged and old adults from the general population, NAFLD is associated with an independent risk of identifying hypertension and high-normal systolic BP. Detection of NAFLD, even with normal ALT levels, should serve as an opportunity to identify metabolic and BP abnormalities and intensify lifestyle modification.
authors.affiliation: Department of Internal Medicine, Virgen del Camino Hospital, Sanlúcar de Barrameda, Cádiz, Spain. a.lopez.ssl@gmail.com
authors.forename: Alejandro
authors.initials: A
authors.lastname: López-Suárez
authors.forename: José María Rodríguez
authors.initials: JM
authors.lastname: Guerrero
authors.forename: Javier
authors.initials: J
authors.lastname: Elvira-González
authors.forename: Manuel
authors.initials: M
authors.lastname: Beltrán-Robles
authors.forename: Francisco
authors.initials: F
authors.lastname: Cañas-Hormigo
authors.forename: Antonio
authors.initials: A
authors.lastname: Bascuñana-Quirell
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005234:Fatty Liver / Q000150:complications / Q000201:enzymology / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000201:enzymology; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D000410:Alanine Transaminase