ARTERIAL HYPERTENSION AND NON-ALCOHOLIC FATTY LIVER DISEASE AS COMPONENTS OF THE METABOLIC syndrome

Abstract

Metabolic syndrome (MS) is a “global epidemic” of our time which makes not only significant influence on the humans health as risk factor for morbidity and mortality, but also spreads among various age groups. An additional component not included in the “classic” definition of MS is non alcoholic fatty liver disease (NAFLD). The combination of NAFLD and arterial hypertension (AH) requires a special approach. The synergistic effect of these diseases increases the risk of complications, especially of cardiovascular system. Diagnosis of NAFLD in connection with a long asymptomatic course often occurs accidentally when the patient is contacted for another reason, in particular with an increase of blood pressure. When examining a patient with hypertension, specialists pay little attention to the condition of the liver. A slight increase in anamnesis (especially alcohol) and examination (level of transaminases, alkaline phosphatase, gamma glutamine transpeptidase, total bilirubin, liver ultrasound, elastometry, FibroMax, FibroMetr) will help the doctor in the diagnosis of NAFLD. Weight loss through diet and regular physical activity are the recommendations for lifestyle changes that are effective for both pathologies. Among antihypertensive drugs, hydrophilic, excreted through the kidneys, lisinopril, which is hydrophilic and excreted through the kidneys, is preferred. If possible, drugs with a negative metabolic profile are excluded: thiazide and thiazide like diuretics, β-blockers. Hepatoprotectors, statins, fibrates, ursodesoxycholic acid based drugs are used to improve the condition of the liver. The management of patients with MS or its individual components requires a multifaceted multidisciplinary approach and careful attention to the patient, his complaints and test results.