Abnormal liver function is often accompanied by high blood pressure! A study of 20 million Chinese people

Recently, a study of 20 million Chinese people showed that elevated alanine aminotransferase levels indicate abnormal liver metabolism and may be involved in the development of hypertension.

Studies have shown that the prevalence of hypertension among residents with elevated alanine aminotransferase levels is 8.56%, which is significantly higher than that among residents with normal alanine aminotransferase levels (3.63%).

After taking into account potential confounding factors, alanine aminotransferase levels and hypertension showed a strong linear relationship.

Note: Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg; covariates included age, sex, race, region, education level, body mass index, average salt intake, history of diabetes, and hepatitis B surface antigen status

Figure 1 Serum alanine aminotransferase level and risk of hypertension

Elevated serum alanine aminotransferase (>40 U/L) increased the risk of hypertension by 55%.

Compared with people with serum alanine aminotransferase ≤20 U/L, the risk of hypertension in people with serum alanine aminotransferase 20-40, 40-60, 60-80 and >80 increased by 22%, 67%, 78% and 92%, respectively.

After correction for multiple factors, the mean systolic and diastolic blood pressures of subjects with abnormal alanine aminotransferase levels were 1.19 mmHg and 0.88 mmHg higher, respectively, compared with those with normal alanine aminotransferase levels.

For every 20 U/L increase in alanine aminotransferase, systolic blood pressure increased by 1.83 mmHg and diastolic blood pressure increased by 1.20 mmHg.

In addition, the relationship between ALT and elevated BP was even stronger in people who were overweight (BMI ≥ 24 kg/m2), drank alcohol, and smoked.

The study analyzed 21.1 million people who participated in the National Free Prenatal Checkup Program from 2016 to 2017, with a median serum alanine aminotransferase level of 20 U/L. Among them, 4.21% had hypertension and 11.67% had an alanine aminotransferase level >40 U/L.

Source: Jia J, Yang Y, Liu F, et al. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovasc Disord. 2021 Mar 19;21(1):145.

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