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MASLD and Cardiovascular Risk: Mechanisms and Implications for Clinical Practice
Sainan Li1, Michel Toutoungy1, Janvi Patel1
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
Current Hypertension Reports
|August 1, 2026
Summary
Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases cardiovascular risk, with fibrosis stage being a key predictor. Emerging therapies offer dual benefits, but their impact on cardiovascular events needs further study.
Area of Science:
- Cardiology
- Hepatology
- Metabolic Syndrome
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, affecting 38% of adults.
- Cardiovascular disease (CVD) is the primary cause of mortality in patients with MASLD.
- MASLD is increasingly understood as a systemic cardiometabolic disease.
Purpose of the Study:
- To review recent advancements in MASLD epidemiology, pathophysiology, biomarkers, and treatment.
- To highlight the implications for cardiovascular risk assessment and management in MASLD patients.
Main Methods:
- Literature review of recent studies on MASLD.
- Analysis of epidemiological data, pathophysiological mechanisms, and therapeutic interventions.
- Evaluation of noninvasive biomarkers for risk stratification.
Main Results:
- Fibrosis stage in MASLD is the strongest independent predictor of cardiovascular outcomes, increasing risk by up to 2.5-fold.
- Noninvasive tools like FIB-4 and liver stiffness measurement can predict cardiovascular mortality.
- New therapies like semaglutide and resmetirom show promise for combined hepatic and cardiometabolic benefits.
Conclusions:
- Fibrosis-based risk stratification is crucial for MASLD management but is currently underutilized in standard cardiovascular risk models.
- While novel therapies offer potential dual benefits, further research is needed to confirm if liver disease improvement translates to reduced cardiovascular events.
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