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Blood Pressure Trajectories in Young Adulthood and Midlife Steatotic Liver Disease
Yun Chen1, Longgang Zhao1, Yinan Zheng2
1Yale School of Nursing, Orange, CT (Y.C., L.Z., Xuehong Zhang).
Insights
Longitudinal blood pressure (BP) trajectories from young adulthood are linked to increased midlife steatotic liver disease (SLD) risk. Rapidly increasing BP trajectories showed the highest association with developing SLD.
Area of Science:
- Cardiovascular Health
- Hepatology
- Public Health
Background:
- High blood pressure (BP) is a known risk factor for steatotic liver disease (SLD).
- The association between longitudinal BP trajectories from young adulthood and midlife SLD remains unclear.
Purpose of the Study:
- To investigate the relationship between long-term blood pressure (BP) patterns starting in young adulthood and the risk of developing steatotic liver disease (SLD) in midlife.
- To determine if different BP trajectories and hypertension development influence midlife SLD risk.
Main Methods:
- Utilized data from the prospective CARDIA study (Coronary Artery Risk Development in Young Adults) cohort.
- Evaluated diastolic and systolic BP, and hypertension trajectories over 25 years using up to 8 BP measures.
- Assessed steatotic liver disease (SLD) at 25-year follow-up using noncontrast abdominal computed tomography scans.
Main Results:
- Higher prevalence of SLD was observed in participants with moderate-stable, moderate-increasing, elevated-stable, and elevated-increasing diastolic BP trajectories compared to a low-stable BP group.
- Systolic BP trajectories also showed similar positive associations with SLD risk.
- Developing hypertension at any stage (early, mid-adulthood, or late-onset) significantly increased SLD risk, with a faster rate of BP increase linked to higher risk.
Conclusions:
- Long-term BP and hypertension patterns established in young adulthood are independently associated with increased midlife SLD risk.
- Rapidly increasing BP trajectories present the greatest risk for developing SLD.
- Monitoring long-term BP changes may improve identification of individuals at higher risk for SLD.
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.
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