Association between hepatic steatosis and blood pressure: analysis of the NHANES 2017- 2020

Abstract

Abstract Background Recent studies have shown that hepatic steatosis is associated with increased risk of incidence hypertension and cardiovascular events, whether the association between hepatic steatosis stratified by controlled attenuation parameter (CAP) grading and blood pressure remains unclear. Methods We examined a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 that included participants ≥18 years old. CAP, the indicator for hepatic steatosis, was obtained from Fibroscan™ and was stratified into four grading groups, including absent (S0): CAP <238 dB/m, mild (S1): 238-260 dB/m, moderate (S2): 260-290 dB/m, severe (S3): 290-400 dB/m. We used multiple linear regression to examine the association between the degree of hepatic steatosis and blood pressure. Results Of 9,698 patients with Fibroscan™ results, the mean age was 44+/-20 years old, and 49.9% were female. We observed that White individuals accounted for 33.7%, followed by Black (26.3%), Mexican American (12.5%), Asians (11.7%), Hispanic (10.1%), and others (5.6%). The mean SBP and DBP were 121±18 and 72±11 mmHg, respectively. Participants with S1, S2, and S3 steatosis had significantly higher SBP values of 4.7, 6.1, and 8.1 mmHg and DBP values of 3.4, 4.8, and 7.1 mmHg, respectively, compared with those without steatosis (S0) (β SBP S1: 4.7, 95%CI 3.4, 5.9; S2: 6.1, 95%CI 5.0, 7.3; S3: 8.1, 95%CI 7.2, 9.0 and β DBP S1: 3.4, 95%CI 2.7, 4.2; S2: 4.8, 95%CI 4.1, 5.5; S3: 7.1, 95%CI 6.6, 7.7). After adjusting for age, gender, race, BMI, smoking status, diabetic status, and serum creatinine, a positive correlation between hepatic steatosis and blood pressure was still observed. Specifically, there was a 1.7, 1.6, and 2.7 mmHg statistically increase in SBP values and a 1.8, 2.3, and 3.9 mmHg increase in DBP values among participants with S1, S2, and S3 steatosis, respectively. (β SBP S1: 1.7, 95%CI 0.5, 3.0; S2: 1.6, 95%CI 0.4, 2.8; S3: 2.7, 95%CI 1.6, 3.8 and β DBP S1: 1.8, 95%CI 0.9, 2.7; S2: 2.3, 95%CI 1.5, 3.1; S3: 3.9, 95%CI 3.2, 4.6). Conclusion The degree of hepatic steatosis is positively associated with blood pressure values. However, further studies are required to demonstrate the long-term clinical outcomes of this observed relationship.