New study shows high blood pressure is deadlier than diabetes in fatty liver disease

New research from USC shows that high blood pressure — not diabetes — poses the highest risk of death in patients with fatty liver disease (MASLD), prompting experts to rethink treatment priorities. (Image: Pexels)

If you thought diabetes was the biggest threat to those with fatty liver disease, think again. In a startling turn of medical understanding, scientists at the University of Southern California have uncovered a trio of cardiometabolic culprits responsible for most deaths in patients suffering from the world’s most common liver condition — Metabolic dysfunction-associated steatotic liver disease (MASLD). Affecting more than a third of the global population, MASLD has long flown under the radar, but this new research is shining an urgent light on the real dangers hiding in plain sight.

Researchers from Keck Medicine of USC analysed over 30 years of health data and uncovered a surprising truth—high blood pressure, not diabetes, is the most fatal risk factor for people living with MASLD. The study, published in Clinical Gastroenterology and Hepatology, shows that high blood pressure increases the risk of death by 40%, followed by diabetes (25%) and low levels of HDL, or “good” cholesterol (15%). Even more revealing, these dangers held true regardless of the patient’s gender, race or ethnicity. It's the kind of revelation that could reshape how doctors approach fatty liver treatment — and save lives in the process.

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The study makes one thing clear—having just one of these conditions is bad, but having more than one, is deadly. Here’s what the study found:

• High blood pressure – Most dangerous of all, increasing mortality by a staggering 40%.
• Diabetes (Type 2 or prediabetes) – Boosts death risk by 25%, less than expected.
• Low HDL cholesterol – Often overlooked, yet raises death odds by 15%.
• Obesity/BMI – Not among the top three killers, but still a major player. The higher the BMI, the higher the risk.
• Multiple risk factors – Every additional condition increased risk of death by another 15%.

Dr Norah Terrault, senior author of the study, believes the findings should prompt a shift in how MASLD is treated. “Knowing what drives poor outcomes lets us better focus our efforts,” she explained.

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The team plans to expand their research by exploring genetics, alcohol use, and diet, in hopes of creating a full risk profile for patients, before it’s too late.

FAQs on MASLD and Blood Pressure:

1. What is Metabolic dysfunction-associated steatotic liver disease (MASLD)?
MASLD is the most common liver condition globally, affecting more than a third of the population. It involves the accumulation of fat in the liver due to metabolic dysfunction.

2. How does high blood pressure affect MASLD patients?
High blood pressure has been found to be the most dangerous risk factor for MASLD patients, increasing the risk of death by 40%.

3. Why is high blood pressure more concerning than diabetes for MASLD patients?
While diabetes increases the risk of death by 25%, high blood pressure poses a greater threat, as revealed by new research, increasing the risk by 40%.

4. What other factors increase the mortality risk in MASLD patients?
Besides high blood pressure and diabetes, low levels of HDL cholesterol and high BMI also contribute to increased mortality risks in MASLD patients.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for a specific health diagnosis.