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NAFLD associated with high BP, hypertension in children

Pediatric patients with nonalcoholic fatty liver disease were more likely to have high blood pressure and persistent high blood pressure compared with children without nonalcoholic fatty liver disease, according to data from a new study.

“Along with being at an increased risk for cardiovascular disease, we found that children with NAFLD who had high [BP] were significantly more likely to have more fat in their liver than children without high [BP],” researcher Jeffrey Schwimmer, MD, of the department of pediatrics, UC San Diego School of Medicine, said in a press release. “This could lead to a more serious form of liver disease.”

Jeffrey Schwimmer

In a multicenter, longitudinal cohort study, Schwimmer and colleagues from the NIH Nonalcoholic Steatohepatitis Clinical Research Network compared BP at enrollment and 48 weeks of 484 children with NAFLD. All patients were aged 2 to 17 years (mean age, 13.1 years), 27.5% had NAFLD, but not NASH, 44.7% had borderline NASH and 27.7% had NASH. Of all the children, 382 were included in the final analysis.

High BP was prevalent in 35.8% of children. High BMI was more prevalent among children with high BP compared with children without high BP (P<.0001), as well as more severe steatotis (P=.003). In addition, children with high BP also showed signs of higher gamma-glutamyl transferase, LDL cholesterol, serum fasting insulin and uric acid levels.   

“As a result of our study, we recommend that [BP] evaluation, control and monitoring should be included as an integral component of the clinical management of children with NAFLD, especially because this patient population is at greater risk for heart attacks and strokes,” Schwimmer said. “Hypertension is a main cause of preventable death and disability in the United States in adults, but much of the origin begins in childhood.”

Persistent high BP was prevalent in 21.4% of children; girls with NAFLD were more likely to have persistent high BP than boys with NAFLD (28.4% vs. 18.9%). Boys with NAFLD were 45% less likely to have persistent high BP than girls with NAFLD.

Eighteen percent of children with high BP were diagnosed with hypertension at baseline. At 48 weeks, 28% of children with persistent high BP had hypertension and 13% were taking medication for it.

“Parents and doctors need to be aware of the health risks of children who have NAFLD. The sooner high [BP] is identified and treated in this patient population, the healthier they will be as they transition in to adulthood,” Schwimmer said.

Disclosure: Relevant financial disclosures were not provided by researchers.