Heart diseases caused by fatty liver: Understanding the link between metabolic dysfunction and cardiovascular health

Fatty liver disease , including Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), is increasingly recognised as a major global health concern. While it primarily affects the liver, research shows it also has significant effects on overall health, particularly the heart. Individuals with fatty liver are at higher risk of developing cardiovascular problems such as atherosclerosis, coronary artery disease , and heart failure . Factors like chronic inflammation, insulin resistance , and altered lipid metabolism link liver fat accumulation to heart health. Early detection, lifestyle changes, and medical management are essential to reduce risks and protect both liver and cardiovascular function.



Understanding fatty liver disease and its link with heart disease
Fatty liver disease occurs when excess fat accumulates in liver cells. In MASLD, this condition arises in individuals without significant alcohol consumption, often linked to obesity, type 2 diabetes, and metabolic syndrome. The disease progresses through stages:

• Simple steatosis: Fat accumulation without inflammation.
• Non-Alcoholic Steatohepatitis (NASH): Fat accumulation accompanied by inflammation and liver cell damage.
• Cirrhosis: Severe scarring of the liver tissue.
• Liver cancer: Development of malignant cells in the liver.

Early stages often present no symptoms, making early detection challenging.



Heart conditions caused by fatty liver disease
Emerging research indicates a robust association between fatty liver disease and various cardiovascular conditions:


Atherosclerosis

Fatty liver disease contributes to the buildup of plaques in arteries, leading to narrowed and hardened arteries. This occurs because excess fat in the liver can increase systemic inflammation and promote the accumulation of cholesterol-rich deposits in blood vessels. Over time, these plaques reduce blood flow, increase blood pressure, and significantly raise the risk of stroke and heart attack. A study published in Hypertension discusses how non-alcoholic fatty liver disease (NAFLD) is a risk factor for atherosclerotic cardiovascular disease, which is the principal cause of death in patients with NAFLD.


Coronary artery disease

Individuals with fatty liver are at a higher risk of developing blockages in the coronary arteries, which supply blood to the heart muscle. The combination of insulin resistance, dyslipidemia, and chronic inflammation associated with fatty liver accelerates the progression of CAD. This can manifest as chest pain (angina), shortness of breath, or, in severe cases, a heart attack. A study published in The Lancet Regional Health – Europe highlights that metabolic dysfunction-associated steatohepatitis (MASH), a severe form of fatty liver disease, can lead to liver scarring (fibrosis), cardiovascular disease, chronic kidney disease, and liver cancer


Heart failure

Fatty liver disease may elevate the risk of heart failure, a condition where the heart cannot pump blood effectively to meet the body’s needs. Chronic metabolic stress from fatty liver can lead to structural and functional changes in the heart, including thickening of the heart walls (left ventricular hypertrophy) and reduced cardiac efficiency. People with fatty liver are also more likely to develop high blood pressure, further contributing to heart failure risk.


Arrhythmias

A study in Nature Reviews Gastroenterology and Hepatology explores the risk of cardiomyopathy and cardiac arrhythmias in patients with nonalcoholic fatty liver disease, highlighting the underlying mechanisms and clinical implications. The presence of fatty liver is linked to an increased risk of abnormal heart rhythms, including atrial fibrillation. Systemic inflammation, oxidative stress, and electrolyte imbalances associated with fatty liver can disrupt the electrical signaling of the heart. Arrhythmias can increase the risk of stroke, reduce cardiac efficiency, and, in severe cases, lead to sudden cardiac arrest.


Notably, cardiovascular disease has become the leading cause of death in individuals with fatty liver disease, surpassing liver-related complications



Mechanisms linking fatty liver to heart disease

Several mechanisms explain the connection between fatty liver disease and cardiovascular conditions:

• Inflammation: Chronic inflammation in the liver can lead to systemic inflammation, affecting blood vessels and heart tissue.
• Insulin resistance: Fatty liver is often associated with insulin resistance, a precursor to type 2 diabetes, which is a significant risk factor for heart disease.
• Dyslipidemia: Altered lipid metabolism in fatty liver disease leads to increased levels of harmful cholesterol and triglycerides, contributing to plaque formation in arteries.
• Oxidative stress: Excess fat in the liver can produce reactive oxygen species, damaging blood vessels and heart tissue.

These factors collectively increase the risk of developing cardiovascular diseases in individuals with fatty liver.



Importance of early detection and management
Given the asymptomatic nature of early-stage fatty liver disease, regular screening is crucial, especially for individuals with risk factors such as obesity, diabetes, and metabolic syndrome. Early detection allows for timely intervention, which may include lifestyle modifications like dietary changes, increased physical activity, and weight management. In some cases, medications may be prescribed to manage associated conditions like diabetes and high cholesterol.



Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making any changes to your health routine or treatment.



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