Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Hypertension and fatty liver: guilty by association?

Journal of Human Hypertension volume 21, pages 264–270 (2007)Cite this article

Abstract

Essential hypertension is associated with the metabolic syndrome, insulin resistance and the development of fatty liver. Fatty liver disease is a spectrum of liver diseases ranging from simple hepatic steatosis through steato-hepatitis to cirrhosis and hepatoma. The purpose of this review is to discuss the evidence for an association between essential hypertension and non-alcoholic fatty liver disease, and to consider the diagnosis and management of non-alcoholic fatty liver disease. We conclude that it is important to consider the diagnosis of fatty liver disease in hypertensive patients, to measure the liver function tests at diagnosis and not to ignore minor elevations of serum aminotransferases. Hypertensive patients with raised liver enzymes should be referred for further assessment, particularly if risk factors for progressive liver disease, such as obesity and diabetes, are present.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Yu AS, Keeffe EB . Nonalcoholic fatty liver disease. Rev Gastroenterol Disord 2002; 2: 11–19.

    PubMed  Google Scholar 

  2. Chitturi S, Farrell GC, George J . Non-alcoholic steatohepatitis in the Asia-Pacific region: future shock? J Gastroenterol Hepatol 2004; 19: 368–374.

    PubMed  Google Scholar 

  3. Younossi Z, Diehl A, Ong J . Non alcoholic fatty liver disease: an agenda for clinical research. Hepatology 2002; 35: 746–752.

    PubMed  Google Scholar 

  4. Bellentani S, Saccoccio G, Masutti F, Croce LS, Brandi G, Sasso F et al. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 2000; 132: 112–117.

    CAS  PubMed  Google Scholar 

  5. Powell E, Cooksley W, Hanson R, Searle J, Halliday JW, Powell LW . The natural history of nonalcoholic steatohepatitis: a follow-up study of forty-two patients for up to 21 years. Hepatology 1990; 11: 74–80.

    PubMed  Google Scholar 

  6. Falck-Ytter Y, Younossi Z, Marchesini G, McCullough AJ . Clinical features and natural history of non alcoholic steatosis syndromes. Semin Liver Dis 2001; 21: 17–26.

    CAS  PubMed  Google Scholar 

  7. Teli M, James O, Burt A, Bennett MK, Day CP . The natural history of non-alcoholic fatty liver: a follow-up study. Hepatology 1995; 22: 1714–1719.

    CAS  PubMed  Google Scholar 

  8. Lee R . Nonalcoholic steatohepatitis: a study of 49 patients. Hum Pathol 1989; 20: 594–598.

    CAS  PubMed  Google Scholar 

  9. Angulo P, Keach J, Batts K, Lindor KD . Independent predictors of liver fibrosis in patients with non-alcoholic steatohepatitis. Hepatology 1999; 30: 1356–1362.

    CAS  PubMed  Google Scholar 

  10. Greeve M, Ferrell L, Kim M, Combs C, Roberts J, Ascher N et al. Cirrhosis of undefined pathogenesis: absence of evidence for unknown or autoimmune process. Hepatology 1993; 17: 594–598.

    Google Scholar 

  11. Ferrannini E, Buzzigoli G, Bonadonna R, Giorico MA, Oleggini M, Graziadei L et al. Insulin resistance in essential hypertension. N Engl J Med 1987; 317: 350–357.

    CAS  PubMed  Google Scholar 

  12. Pollare T, Lithell H, Berne C . Insulin resistance is a characteristic feature of primary hypertension independent of obesity. Metabolism 1990; 39: 167–174.

    CAS  PubMed  Google Scholar 

  13. Freedman DS, Khan LK, Serdula MK, Galuska DA, Dietz WH . Trends and correlates of class 3 obesity in the United States from 1990 through 2000. JAMA 2002; 288: 1758–1761.

    PubMed  Google Scholar 

  14. Thompson D, Edelsberg J, Colditz GA, Bird AP, Oster G . Lifetime health and economic consequences of obesity. Arch Intern Med 1999; 159: 2177–2183.

    CAS  PubMed  Google Scholar 

  15. Meigs JB . Epidemiology of the insulin resistance syndrome. Curr Diab Rep 2003; 3: 73–79.

    PubMed  Google Scholar 

  16. Steinberg H, Tarshoby M, Monestel R, Hook G, Cronin J, Johnson A et al. Elevated circulating free fatty acid levels impair endothelium-dependent vasodilator. J Clin Invest 1997; 100: 1230–1239.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Laakso M, Edelman S, Brechtel G, Baron AD . Decreased effect of insulin to stimulate skeletal blood flow in obese man. A novel mechanism for insulin resistance. J Clin Invest 1990; 85: 1844–1852.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Ramsay LE . Liver dysfunction in hypertension. Lancet 1977; 2: 111–114.

    CAS  PubMed  Google Scholar 

  19. van Barneveld T, Seidell JC, Traag N, Hautvast JG . Fat distribution and gamma-glutamyl transferase in relation to serum lipids and blood pressure in 38-year old Dutch males. Eur J Clin Nutr 1989; 43: 809–818.

    CAS  PubMed  Google Scholar 

  20. Nilssen O, Forde OH, Brenn T . The Tromso Study. Distribution and population determinants of γ-glutamyltransferase. Am J Epidemiol 1990; 132: 318–326.

    CAS  PubMed  Google Scholar 

  21. Yamada Y, Ishizaki M, Kido T, Honda R, Tsuritani I, Ikai E et al. Alcohol, high blood pressure, and serum gamma-glutamyl transpeptidase level. Hypertension 1991; 18: 819–826.

    CAS  PubMed  Google Scholar 

  22. Ikai E, Honda R, Yamada Y . Serum gamma-glutamyl transpeptidase level and blood pressure in nondrinkers: a possible pathogenetic role of fatty liver in obesity-related hypertension. J Hum Hypertens 1994; 8: 95–100.

    CAS  PubMed  Google Scholar 

  23. Miura K, Nakagawa H, Nakamura H, Tabata M, Nagase H, Yoshida M et al. Serum γ-glutamyl transferase level in predicting hypertension among male drinkers. J Hum Hypertens 1994; 8: 445–449.

    CAS  PubMed  Google Scholar 

  24. Yamada Y, Ikai E, Tsuritani I, Ishizaki M, Honda R, Ishida M . The relationship between serum gamma-glutamyl transpeptidase levels and hypertension: common in drinkers and nondrinkers. Hypertens Res 1995; 18: 295–301.

    CAS  PubMed  Google Scholar 

  25. Lee DH, Ha MH, Kim JR, Gross M, Jacobs Jr DR . Glutamytransferase alcohol and blood pressure: a four year follow-up study. Ann Epidemiol 2002; 12: 90–96.

    PubMed  Google Scholar 

  26. Lee DH, Ha MH, Kim KY, Jin DG, Jacobs Jr DR . Gamma-glutamyltransferase: an effect modifier in the association between age and hypertension in a 4-year follow-up study. J Hum Hypertens 2004; 18: 803–807.

    CAS  PubMed  Google Scholar 

  27. Stranges S, Trevisan M, Dorn JM, Dmochowski J, Donahue RP . Body fat distribution, liver enzymes, and risk of hypertension: evidence from the Western New York study. Hypertension 2005; 46: 1186–1193.

    CAS  PubMed  Google Scholar 

  28. Dixon JB, Bhathal PS, O'Brien PE . Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 2001; 121: 91–100.

    CAS  PubMed  Google Scholar 

  29. Donati G, Stagni B, Piscaglia F, Venturoli N, Morselli-Labate AM, Rasciti L et al. Increased prevalence of fatty liver in arterial hypertensive patients with normal liver enzymes: role of insulin resistance. Gut 2004; 53: 1020–1023.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, Mcullough AJ et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 1999; 107: 450–455.

    CAS  PubMed  Google Scholar 

  31. Belfiore F, Ianello S . Insulin resistance in obesity: metabolic mechanisms and measurement methods. Mol Genet Metab 1998; 65: 121–128.

    CAS  PubMed  Google Scholar 

  32. Alberti KG, Zimmet P, Shaw J . Metabolic syndrome – a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med 2006; 23: 469–480.

    CAS  PubMed  Google Scholar 

  33. Salmela PI, Sotaniemi EA, Niemi M, Maentausta O . Liver function tests in diabetic patients. Diabetes Care 1984; 7: 248–254.

    CAS  PubMed  Google Scholar 

  34. El-Serag HB, Tran T, Everhart JE . Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma. Gastroenterology 2004; 126: 460–468.

    PubMed  Google Scholar 

  35. Amarapurkar D, Das HS . Chronic liver disease in diabetes mellitus. Trop Gastroenterol 2002; 23: 3–5.

    CAS  PubMed  Google Scholar 

  36. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA . Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology 1994; 107: 1103–1109.

    CAS  PubMed  Google Scholar 

  37. Uygun A, Kadayifci A, Yesilova Z, Erdil A, Yaman H, Saka M . Serum leptin levels in patients with non-alcoholic steatohepatitis. Am J Gastroenterol 2000; 95: 3584–3589.

    CAS  PubMed  Google Scholar 

  38. Assy N, Kaita K, Mymin D, Levy C, Rosser B, Minuk G . Fatty infiltration of liver in hyperlipidaemic patients. Dig Dis Sci 2000; 45: 1929–1934.

    CAS  PubMed  Google Scholar 

  39. Sheth SG, Gordon FD, Chopra S . Nonalcoholic steatohepatitis. Ann Intern Med 1997; 126: 137–145.

    CAS  PubMed  Google Scholar 

  40. Andersen T, Christoffersen P, Gluud C . The liver in consecutive patients with morbid obesity: a clinical, morphological, and biochemical study. Int J Obes Relat Metab Disord 1984; 8: 107–115.

    CAS  Google Scholar 

  41. Marceau P, Biron S, Hould FS, Marceau S, Simard S, Thung SN et al. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Endocrinol Metab 1999; 84: 1513–1517.

    CAS  PubMed  Google Scholar 

  42. Luyckx FH, Lefebvre PJ, Scheen AJ . Non-alcoholic steatohepatitis: association with obesity and insulin resistance, and influence of weight loss. Diabetes Metab 2000; 26: 98–106.

    CAS  PubMed  Google Scholar 

  43. Kral J, Schaffner F, Pierson Jr RN, Wang J . Body fat topography as an independent predictor of fatty liver. Metabolism 1993; 42: 548–551.

    CAS  PubMed  Google Scholar 

  44. Banerji MA, Buckley MC, Chaiken RL, Gordon D, Lebovitz HE, Kral JG . Liver fat, serum triglycerides and visceral adipose tissue in insulin-sensitive and insulin-resistant black men with NIDDM. Int J Obes Relat Metab Disord 1995; 19: 846–850.

    CAS  PubMed  Google Scholar 

  45. Diehl AM . Nonalcoholic steatohepatitis. Semin Liver Dis 1999; 19: 221–229.

    CAS  PubMed  Google Scholar 

  46. Jepsen P, Vilstrup H, Mellemkjaer L, Thulstrup AM, Olsen JH, Baron JA et al. Prognosis of patients with a diagnosis of fatty liver – a registry-based cohort study. Hepatogastroenterology 2003; 50: 2101–2104.

    PubMed  Google Scholar 

  47. Dam Larsen S, Franzmann M, Andersen IB, Christoffersen P, Larsen K, Becker U et al. Long term prognosis of fatty liver: risk of chronic liver disease and death. Gut 2004; 53: 750–755.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. McCullough AJ . The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease. Clin Liver Dis 2004; 8: 521–533.

    PubMed  Google Scholar 

  49. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ . Non-alcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 1999; 116: 1413–1419.

    CAS  PubMed  Google Scholar 

  50. Liou I, Kowdley KV . Natural history of nonalcholic steatohepatitis. J Clin Gastroenterol 2006; 40: S11–S16.

    PubMed  Google Scholar 

  51. Marchesini G, Bugianesi E, Forlani G, Cerrelli M, Lenzi M, Manini R et al. Non-alcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003; 37: 917–923.

    PubMed  Google Scholar 

  52. Marrero JA, Fontana RJ, Su GL, Conjeevaram HS, Fontata RJ, Lok AS . NAFLD may be a common underlying liver disease in patients with hepatocellular carcinoma in the United States. Hepatology 2002; 36: 1349–1354.

    PubMed  Google Scholar 

  53. Adinolfi LE, Gambardella M, Andreana A, Tripodi MF, Utili R, Ruggiero G . Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity. Hepatology 2001; 33: 1358–1364.

    CAS  PubMed  Google Scholar 

  54. Hezode C, Lonjon I, Roudot-Thoraval F, Roudot-Thoraval F, Lonjon I, Bastie A et al. Impact of moderate alcohol consumption on histological activity and fibrosis in patients with chronic hepatitis C, and specific influence of steatosis: a prospective study. Aliment Pharmacol Ther 2003; 17: 1031–1037.

    CAS  PubMed  Google Scholar 

  55. Day CP, James OF . Steatohepatitis: a tale of two ‘hits’? Gastroenterology 1998; 114: 842–845.

    CAS  PubMed  Google Scholar 

  56. Hui JM, Hodge A, Farrell GC, Kench JG, Kriketos A, George J . Beyond insulin resistance in NASH: TNF-alpha or adiponectin. Hepatology 2004; 40: 46–54.

    CAS  PubMed  Google Scholar 

  57. Crespo J, Cayon A, Fernandez-Gil P, Hernandez-Guerra M, Mayorga M, Dominguez-Diez A et al. Gene expression of tumour necrosis alpha and TNF-receptors, p55 and p75, in nonalcoholic steatohepatitis patients. Hepatology 2001; 34: 1158–1163.

    CAS  PubMed  Google Scholar 

  58. Cai D, Yuan M, Frantz DF, Melendez PA, Hansen L, Lee J et al. Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB. Nat Med 2005; 11: 183–190.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Bugianesi E, Pagotto U, Manini R, Vanni E, Gastaldelli A, de Iasio R et al. Plasma adiponectin in non-alcoholic fatty liver is related to hepatic insulin resistance and hepatic fat content, not to liver disease severity. J Clin Endocrinol Metab 2005; 90: 3498–3504.

    CAS  PubMed  Google Scholar 

  60. Yamauchi T, Kamon J, Minokoshi Y, Ito Y, Waki H, Uchida S et al. Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase. Nat Med 2002; 8: 1288–1295.

    CAS  PubMed  Google Scholar 

  61. Masaki T, Chiba S, Tatsukawa H, Yasuda T, Noguchi H, Seike M et al. Adiponectin protects LPS-induced liver injury through modulation of TNF-alpha in KK-Ay obese mice. Hepatology 2004; 40: 177–184.

    CAS  PubMed  Google Scholar 

  62. Kaser S, Moschen A, Cayon A, Kaser A, Crespo J, Pons-Romero F et al. Adiponectin and its receptors in non-alcoholic steatohepatitis. Gut 2005; 54: 117–121.

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Yamauchi T, Kamon J, Ito Y, Tsuchida A, Yokomizo T, Kita S et al. Cloning of adiponectin receptors that mediate antidiabetic metabolic effects. Nature 2003; 423: 762–769.

    CAS  PubMed  Google Scholar 

  64. Maeda N, Takahashi M, Funahashi T, Kihara S, Nishizawa H, Kishida K et al. PPARgamma ligands increase expression and plasma concentrations of adiponectin, and adipose-derived protein. Diabetes 2001; 50: 2094–2099.

    CAS  PubMed  Google Scholar 

  65. Bocher V, Pineda-Torra I, Fruchart JC, Staels B . PPARs: transcription factors controlling lipid and lipoprotein metabolism. Ann NY Acad Sci 2002; 967: 7–18.

    CAS  PubMed  Google Scholar 

  66. Yoshiji H, Kuriyama S, Yoshii J, Ikenaka Y, Noguchi R, Nakatani T et al. Angiotensin-II type 1 receptor interaction is a major regulator for liver fibrosis development in rats. Hepatology 2001; 34: 745–750.

    CAS  PubMed  Google Scholar 

  67. Yokohama S, Yoneda M, Haneda M, Okamoto S, Okada M, Aso K et al. Therapeutic efficacy of an angiotensin II receptor antagonist in patients with nonalcoholic steatohepatitis. Hepatology 2004; 40: 1222–1225.

    CAS  PubMed  Google Scholar 

  68. Youssef W, Mc Cullough AJ . Diabetes mellitus, obesity, and hepatic steatosis. Semin Gastrointest Dis 2002; 13: 17–30.

    PubMed  Google Scholar 

  69. Sorbi D, Boynton J, Lindor KD . The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease. Am J Gastroenterol 1999; 94: 1018–1022.

    CAS  PubMed  Google Scholar 

  70. Neuschwander-Tetri BA, Caldwell SH . Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 2003; 37: 1202–1219.

    PubMed  Google Scholar 

  71. Zhang BB, Cai WM, Weng HL, Hu ZR, Lu J, Zheng M et al. Diagnostic value of platelet derived growth factor-BB, transforming growth factor-beta1, matrix metalloproteinase-1, and tissue inhibitor of matrix metalloproteinase-1 in serum and peripheral blood mononuclear cells for hepatic fibrosis. World J Gastroenterol 2003; 9: 2490–2496.

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Davies RJ, Saverymuttu SH, Fallowfield M, Joseph AE . Paradoxical lack of ultrasound attenuation with gross fatty change in the liver. Clin Radiol 1991; 43: 393–396.

    CAS  PubMed  Google Scholar 

  73. Graif M, Yanuka M, Baraz M, Blank A, Moshkovitz M, Kessler A et al. Quantitative estimation of attenuation in ultrasound video images: correlation with histology in diffuse liver disease. Invest Radiol 2000; 35: 319–324.

    CAS  PubMed  Google Scholar 

  74. Ataseven H, Yildirim MH, Yalniz M, Bahcecioglu IH, Celebi S, Ozercan IH . The value of ultrasonography and computerized tomography in estimating the histopathological severity of nonalcoholic steatohepatitis. Acta Gastroenterol Belg 2005; 68: 221–225.

    CAS  PubMed  Google Scholar 

  75. Szczepaniak LS, Nurenberg P, Leonard D, Browning JD, Reingold JS, Grundy S et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2004; 288: E462–E468.

    PubMed  Google Scholar 

  76. Ueno T . Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol 1997; 27: 103–107.

    CAS  PubMed  Google Scholar 

  77. Hickman IJ, Jonsson JR, Prins JB, Ash S, Purdie DM, Clouston AD et al. Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life. Gut 2004; 53: 413–419.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Barker KB, Palekar NA, Bowers SP, Goldberg JE, Pulcini JP, Harrison SA . Steatohepatitis: effect of Roux-en-Y gastric bypass surgery. Am J Gastroenterol 2006; 101: 368–373.

    PubMed  Google Scholar 

  79. Lin HZ, Yang SQ, Chuckaree C, Kuhajda F, Ronnet G, Diehl AM . Metformin reverses fatty liver disease in obese, leptin-deficient mice. Nat Med 2000; 6: 998–1003.

    CAS  PubMed  Google Scholar 

  80. Nair S, Diehl AM, Wiseman M, Farr Jr GH, Perrillo RP . Metformin in the treatment of non-alcoholic steatohepatitis: an open-label trial. Aliment Pharmacol 2004; 20: 23–28.

    CAS  Google Scholar 

  81. Uygun A, Kadayifci A, Isik AT, Ozgurtas T, Deveci S, Tuzun A et al. Metformin in the treatment of patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2004; 19: 537–544.

    CAS  PubMed  Google Scholar 

  82. Bugianesi E, Gentilcore E, Manini R, Natale S, Vanni E, Villanova N et al. A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol 2005; 100: 1082–1090.

    CAS  PubMed  Google Scholar 

  83. Caldwell SH, Hespenheiden EE, Redick JA, Iezzoni JC, Battle EH, Sheppard BL . A pilot study of thiazolidinedione, troglitazone, in non-alcoholic steatohepatitis. Am J Gastroenterol 2001; 96: 519–525.

    CAS  PubMed  Google Scholar 

  84. Watkins PB, Whitcomb RW . Hepatic dysfunction associated with troglitazone. N Engl J Med 1998; 338: 908–909.

    Google Scholar 

  85. Neuschwander-Tetri BA, Brunt EM, Wehmeier KR, Oliver D, Bacon BR . Improved non-alcoholic steatohepatitis after 48 weeks treatment with the PPAR-gamma ligand rosiglitazone. Hepatology 2003; 38: 1008–1017.

    CAS  PubMed  Google Scholar 

  86. Ono M, Ikegami H, Fugisawa T, Nojima K, Kawabata Y, Nishino M et al. Improvement of liver function parameters in patients with type 2 diabetes treated with thiazolidinediones. Metabolism 2005; 54: 529–532.

    CAS  PubMed  Google Scholar 

  87. Promrat K, Lutchman G, Uwaifo GI, Freedman RJ, Soza A, Heller T et al. A pilot study of pioglitazone treatment for nonalcoholic steatohepatitis. Hepatology 2004; 39: 188–196.

    CAS  PubMed  Google Scholar 

  88. Lavine JE . Vitamin E treatment of non-alcoholic steatohepatitis in children: a pilot study. J Pediatr 2000; 136: 734–738.

    CAS  PubMed  Google Scholar 

  89. Hasegawa T, Yoneda M, Nakamura K, Makino I, Terano A . Plasma transforming growth factor-β1 level and efficacy of α-tocopherol in patients with non-alcoholic steatohepatitis: a pilot study. Aliment Pharmacol Ther 2001; 15: 1667–1672.

    CAS  PubMed  Google Scholar 

  90. Basaranoglu M, Acbay O, Sonsuz A . A controlled trial of gemfibrozil in the treatment of patients with non-alcoholic steatohepatitis. J Hepatol 1999; 31: 384.

    CAS  PubMed  Google Scholar 

  91. Hatzitolios A, Savopoulos C, Lazaraki G, Sidiropoulos I, Haritanti P, Lefkopoulos A et al. Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia. Indian J Gastroenterol 2004; 23: 131–134.

    PubMed  Google Scholar 

  92. Laurin J, Lindor KD, Crippin JS, Gossard A, Gores GJ, Ludwig J et al. Ursodeoxycholic acid or clofibrate in the treatment of non-alcoholic-induced steatohepatitis: a pilot study. Hepatology 1996; 23: 1464–1467.

    CAS  PubMed  Google Scholar 

  93. Vajro P, Franzese A, Valerio G, Iannucci MP, Aragione N . Lack of efficacy of ursodeoxycholic acid for the treatment of liver abnormalities in obese children. J Pediatr 2000; 136: 739–743.

    CAS  PubMed  Google Scholar 

  94. Lindor KD, Kowdley KV, Heathcote EJ, Harrison ME, Jorgensen R, Angulo P et al. Ursodeoxycholic acid for the treatment of nonalcoholic steatohepatitis: results of a randomised trial. Hepatology 2004; 39: 770–778.

    CAS  PubMed  Google Scholar 

  95. Hagmeyer KO, Stein J . Hepatotoxicity associated with carvedilol. Ann Pharmacother 2001; 35: 1364–1366.

    CAS  PubMed  Google Scholar 

  96. Clark JA, Zimmerman HJ, Tanner LA . Labetalol hepatotoxicity. Ann Intern Med 1990; 113: 210–213.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastroenterology Unit, City Hospital, Birmingham, UK

    M J Brookes & B T Cooper

Authors
  1. M J Brookes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B T Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B T Cooper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brookes, M., Cooper, B. Hypertension and fatty liver: guilty by association?. J Hum Hypertens 21, 264–270 (2007). https://doi.org/10.1038/sj.jhh.1002148

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002148

Keywords

This article is cited by

Search

Advanced search

Quick links