Abstract: Objective To investigate the clinical features of metabolic associated fatty liver disease (MAFLD) in patients with hypertension and its relationship with cardio-cerebrovascular events. Methods The clinical data of 1385 patients with hypertension in Dahua Hospital, Xuhui District, Shanghai from January 2019 to October 2022 were retrospectively analyzed. The enrolled cases were divided into MAFLD group and non-MAFLD group according to the presence or absence of MAFLD, and the general clinical characteristics of the two groups were compared. The risk factors of cardio-cerebrovascular events in hypertensive patients were analyzed by the binary logistic regression method. Cardio-cerebrovascular events were defined as fatal or non-fatal cardiovascular and cerebrovascular events, including angina, myocardial infarction, stroke, cardiovascular and cerebrovascular death, and heart failure requiring hospitalization or treatment. The independent risk factors of cardio-cerebrovascular events identified by logistic regression were demonstrated by a nomogram model. The concordance index (C-index) and bootstrap resampling were used to evaluate the predictive ability of the nomogram. Results Among the 1385 hypertensive patients, 514 patients were assigned to the MAFLD group, and 871 patients were to the non-MAFLD group. The patients in the MAFLD group were significantly linked to more male gender and higher rates of alcohol consumption, type 2 diabetes and atrial fibrillation, higher levels of body mass index, 24h mean systolic/diastolic blood pressure, total cholesterol, triglycerides and low-density lipoprotein(LDL), lower level of high-density lipoprotein(HDL), and higher incidence of cardio-cerebrovascular events (24.7% vs 17.8%) (P<0.05), when compared to the non-MAFLD group. Univariate and multivariate logistic regression analysis showed that age, smoking, atrial fibrillation, MAFLD, type 2 diabetes, 24h mean systolic blood pressure, total cholesterol, HDL, LDL and glomerular filtration rate were independent factors affecting cardio-cerebrovascular events in hypertension population (P<0.05). The independent risk factors were used to construct a nomogram model, and the calibration curve showed good agreement between the predicted value and the actual observed value. The C-index was 0.70 (95% confidence interval, 0.65-0.72). Conclusion In the hypertension population, patients with MAFLD are more likely to be male, and inclined to have unhealthy lifestyles, suffer from abnormal blood lipid metabolism and comorbidities. MAFLD is independently correlated with cardio-cerebrovascular events in a hypertension population.

Key words: Metabolic associated fatty liver disease, Hypertension, Cardio-cerebrovascular events, Nomogram, Logistic regression model