Yamashita Sumiyo, Takase Hiroyuki, Kawakatsu Naomi, Hayashi Kazusa, Kin Fumihiko, Isogaki Takeru, Dohi Yasuaki
Department of Cardiology, Nagoya City University Mirai Kousei Hospital, Nagoya, Japan.
Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan.
Hypertens Res. 2025 Feb;48(2):796-804. doi: 10.1038/s41440-024-02028-4. Epub 2024 Dec 5.
The fibrosis-4 index, a noninvasive method for evaluating liver fibrosis, is closely associated with cardiovascular events. In this study, we tested the hypothesis that the fibrosis-4 index is associated with new-onset hypertension in the general population. A total of 15,502 individuals (51.0 ± 13.2 years) who participated in our health checkup program were screened. Participants with hypertension were excluded, and the remaining 8719 normotensive participants (48.4 ± 12.6 years) were followed up (median 1739 days) with the endpoint of the new onset of hypertension. During follow-up, 1750 participants (39.0 per 1000 person-years) developed hypertension. In Kaplan-Meier analysis, where participants were divided into three groups according to the fibrosis-4 index at baseline (low, <1.30; intermediate, 1.30-2.67; high, ≥2.67), the risk of hypertension increased with increasing fibrosis-4 index (low, 33.8; intermediate, 55.2; high, 69.4 per 1000 person-years). Multivariate Cox hazard regression analysis revealed that the log-transformed fibrosis-4 index was independently associated with the development of new hypertension (hazard ratio 4.279, 95% confidence interval 3.318-5.518). These results suggest that the fibrosis-4 index is a useful tool to evaluate a risk of developing hypertension in the general population. Hypertension and liver fibrosis may share a common basis.
纤维化-4指数是一种评估肝纤维化的非侵入性方法，与心血管事件密切相关。在本研究中，我们检验了纤维化-4指数与普通人群新发高血压相关的假设。共有15502名参与我们健康体检项目的个体（51.0±13.2岁）接受了筛查。排除患有高血压的参与者，其余8719名血压正常的参与者（48.4±12.6岁）进行随访（中位随访时间1739天），终点为新发高血压。随访期间，1750名参与者（每1000人年39.0例）发生了高血压。在Kaplan-Meier分析中，根据基线时的纤维化-4指数将参与者分为三组（低，<1.30；中，1.30 - 2.67；高，≥2.67），高血压风险随着纤维化-4指数的升高而增加（低，每1000人年33.8例；中，每1000人年55.2例；高，每1000人年69.4例）。多变量Cox风险回归分析显示，对数转换后的纤维化-4指数与新发高血压独立相关（风险比4.279，95%置信区间3.318 - 5.518）。这些结果表明，纤维化-4指数是评估普通人群发生高血压风险的有用工具。高血压和肝纤维化可能有共同的基础。
