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Bi-directional and temporal relationship between elevated alanine aminotransferase and hypertension in a longitudinal
Guoxin Huang1, Hui Zhou2, Chao Shen2
1Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, PR China.
Objective:
Despite the strong correlation between elevated alanine aminotransferase (ALT) and hypertension, their bi-directional and temporal relationship are currently unclear. Our study aimed to explore the bi-directional and temporal association between elevated ALT (ALT > 40 U/L) and hypertension.
Methods:
Measurements of alanine aminotransferase and blood pressure were obtained twice from 2013 to 2017 in 3314 Chinese adults without cardiovascular disease at baseline. Bi-directional and cross-lagged panel analyses were performed to dissect the temporal relationship between elevated ALT and hypertension.
Results:
Longitudinally, we found that baseline elevated ALT was strongly correlated with incident hypertension (odds ratios = 2.16, P = .001), and baseline hypertension was also significantly associated with incident elevated ALT (odds ratios = 1.64, P = .026). The cross-lagged path coefficients from baseline ALT to follow-up blood pressure were significantly greater than that from baseline blood pressure to follow-up ALT (β: 0.043 vs. 0.026, P < .05 for systolic blood pressure and β: 0.052 vs. 0.024, P < .05 for diastolic blood pressure).
Conclusion:
Our results provide evidence for the bi-directional association of elevated ALT and hypertension among Chinese adults, and elevated ALT probably antedates the development of hypertension.
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