Ambulatory arterial stiffness indices and non-alcoholic fatty liver disease in essential hypertension.
OBJECTIVE
Non-alcoholic fatty liver disease (NAFLD) has been found to be strongly related to an increased arterial stiffness in patients with essential hypertension, suggesting a pathophysiologic link between major cardiovascular and metabolic abnormalities associated with liver steatosis and the functional and structural alterations of the arterial wall. The aim of our study was to investigate, in a group of essential hypertensive patients without additional cardiovascular risk factors, the relationship between NAFLD and arterial stiffness.


RESULTS
Sixty-eight consecutive patients with essential hypertension underwent 24-h ambulatory blood pressure monitoring (ABPM) and were separated according to the presence (n = 40) or absence (n = 28) of NAFLD at liver ultrasonography. The Ambulatory Arterial Stiffness Index (AASI) and Symmetric AASI (Sym-AASI) were derived from ABPM tracings. Patients with diabetes, obesity, hyperlipidaemia or other risk factors for cardiovascular or liver disease were excluded. Hypertensive patients were compared with a normotensive control group.The two hypertensive groups had comparable age, sex distribution and clinic/ABPM blood pressure levels. In hypertensive patients with NAFLD, body mass index, fasting glucose, insulin, homeostasis model of assessment of insulin resistance index and triglyceride levels were higher, whereas plasma adiponectin was lower than in patients without NAFLD. In hypertensive patients, AASI and Sym-AASI were higher (P < 0.001) than in normotensive subjects, but both indices of vascular stiffness were comparable in patients with and without NAFLD.


CONCLUSIONS
In essential hypertensive patients without additional cardiovascular risk factors, NAFLD is associated with insulin resistance but not with increased arterial stiffness.
Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy.
C
C
Catena
S
S
Bernardi
N
N
Sabato
A
A
Grillo
M
M
Ermani
L A
LA
Sechi
B
B
Fabris
R
R
Carretta
F
F
Fallo
D000328:Adult; D000704:Analysis of Variance; D062186:Arterial Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography; D059289:Vascular Stiffness