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      Nonalcoholic Fatty Liver Disease : An Emerging Driver of Hypertension

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          Abstract

          Hypertension, a multifactorial disorder resulting from the interplay between genetic predisposition and environmental risk factors, affects ≈30% of adults. Emerging evidence has shown that nonalcoholic fatty liver disease (NAFLD), as an underestimated metabolic abnormality, is strongly associated with an increased risk of incident prehypertension and hypertension. However, the role of NAFLD in the development of hypertension is still obscure and is highly overlooked by the general public. Herein, we highlight the epidemiological evidence and putative mechanisms focusing on the emerging roles of NAFLD in hypertension, with the purpose of reinforcing the notion that NAFLD may serve as an independent risk factor and an important driving force in the development and progression of hypertension. Finally, we also briefly summarize the current potential treatments for NAFLD that might also be beneficial approaches against hypertension.

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          Most cited references101

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          The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

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            2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

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              The gut–liver axis and the intersection with the microbiome

              In the past decade, an exciting realization has been that diverse liver diseases, ranging from non-alcoholic steatohepatitis, alcoholic steatohepatitis, and cirrhosis, to hepatocellular carcinoma, are not unrelated but fall along a spectrum. Recent work on the biology of the gut-liver communication axis has assisted in understanding the basic biology of both alcoholic and nonalcoholic fatty liver disease. Of immense importance is the massive advancement in understanding of the role of the microbiome, driven by high-throughput DNA sequencing and improved computational techniques that allow the complexity of the microbiome to be interrogated, together with improved experimental designs. Here, we review the gut-liver communications of these various forms of liver disease, explore the molecular, genetic and microbiome relationships, discuss prospects for exploiting the microbiome to determine the stage of liver disease, and to predict the effects of pharmaceutical, dietary, and other interventions at a population and individual level. We conclude that although much remains to be done in understanding the relationship between the microbiome and liver disease, rapid progress towards clinical applications is being made, especially in study designs that complement human intervention studies with mechanistic work in mice that have been humanized in multiple respects, including the genetic, immunological and microbiome characteristics of individual patients. These “avatar mice” may be especially useful for guiding new microbiome-based or microbiome-informed therapies.
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                Author and article information

                Journal
                Hypertension
                Hypertension
                Ovid Technologies (Wolters Kluwer Health)
                0194-911X
                1524-4563
                February 2020
                February 2020
                : 75
                : 2
                : 275-284
                Affiliations
                [1 ]From the Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, P.R. China (Y.-C.Z., G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
                [2 ]Institute of Model Animal of Wuhan University, P.R. China (Y.-C.Z.,G.-J.Z., Z.C., Z.-G.S., J.C., H.L.)
                [3 ]Basic Medical School (Z.-G.S., H.L.), Wuhan University, P.R. China.
                [4 ]Medical Research Institute, School of Medicine (Z.-G.S.), Wuhan University, P.R. China.
                [5 ]Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, P.R. China (J.C.)
                Article
                10.1161/HYPERTENSIONAHA.119.13419
                31865799
                a4958be5-b228-45a8-b763-d9ace784391f
                © 2020
                History

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