The risk of heart failure increases with fatty liver -

Accumulation of fat in the liver increases the risk of heart failure

According to a recent study, the presence of non-alcoholic fatty liver disease is associated with an increased risk of developing heart failure over the next decade. Hepatic steatosis therefore seems to be a risk factor for heart failure so far underestimated.

The editors of the famous "British Medical Journal (BMJ)" present the results of an Italian research team from the University of Verona. The working group brought together the results of eleven long-term international observational studies in order to clarify the link between fatty liver disease and heart failure. The study was recently published in the journal Gut.

Fatty liver disease is common

Around 30% of all adults worldwide have already developed fatty liver disease. Due to the general increase in the prevalence of overweight and obesity, which are among the main risk factors for the development of fatty liver disease, an increasing trend in fatty liver disease is expected in the coming years.

Fatty liver disease as a previously unknown risk factor for heart failure

Diabetes, high blood pressure and other cardiovascular risk factors are considered the main causes for the development of heart failure. The latest meta-analysis suggests that fatty liver also increases the risk of heart failure. Due to the widespread spread of fatty liver disease, the findings could be of great medical relevance.

It was previously known that fatty liver disease increased the risk of serious liver diseases such as liver cancer, liver cirrhosis and liver fibrosis. Fatty liver has only recently been associated with the development of heart failure.

course of the study

To verify the connection, the research team analyzed data collected from eleven long-term studies. In this way, the information of more than eleven million adults from different countries could be evaluated. The studies were conducted in Sweden, Finland, the United States, South Korea and Great Britain.

Just over one in four people (26%) had fatty liver disease. Heart failure was diagnosed in nearly 100,000 participants over an average follow-up period of ten years.

Study results

Those who had developed fatty liver disease at the start of the study were 50% more likely to be diagnosed with heart failure over a 10-year period compared to those who did not have an accumulation of fatty liver disease.

This risk was independent of the subjects' age, sex and body fat percentage. Similarly, the additional risk was independent of the presence of other known risk factors for heart failure, such as diabetes and high blood pressure.

The risk of heart failure associated with fatty liver disease also appears to increase with the severity of fatty liver disease. In people who had already developed fibrosis (scar tissue) in the liver, the risk of heart failure was increased by 76%.

Why fatty liver can lead to heart failure

Researchers have several possible explanations why fatty liver disease could increase the risk of heart failure. On the one hand, fatty liver disease exacerbates systemic insulin resistance and, on the other hand, it promotes the formation of plaques in the blood vessels.

Also, if the liver is fatty, more substances are released into the body that promote inflammation and have a thickening effect on the blood. However, the exact reasons for the link and causation must first be verified and confirmed in further studies. (vb)

Author and source information

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This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.


Graduate editor (FH) Volker Blasek


Alessandro Mantovani, Graziana Petracca, Alessandro Csermely, et al. : Nonalcoholic fatty liver disease and risk of new-onset heart failure: an updated meta-analysis of approximately 11 million people; in: Gut (2022), gut.bmj.comBMJ Media Relations: Fat build-up in liver (NAFLD) related to high heart failure risk over the next decade (published: 25/07/2022),

Important note:
This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.