Association between hypertension and fatty liver index in patients undergoing coronary computed tomography angiography: a cross-sectional study.

Fatty Liver Index (FLI) is associated with hypertension (HTN) in individuals undergoing general health screening and patients with hepatic steatosis; however, whether it is associated with HTN in patients undergoing coronary computed tomography angiography (CCTA) remains unclear. Therefore, to investigate this association, we conducted a cross-sectional study involving 1 173 patients with clinically suspected coronary artery disease. The primary outcomes of interest were FLI values and HTN prevalence. The mean FLI was 36.3 ± 25.8. Patients with HTN had a significantly higher FLI than those without HTN (39.1 ± 26.0 vs. 30.9 ± 24.7; P < 0.001). FLI was divided into three value-based categories, lower, intermediate, and higher; the HTN prevalence among them was 59.2%, 69.0%, and 75.6%, respectively, showing a significant linear trend (P < 0.001). A higher FLI was independently associated with HTN in a dose-response manner. Compared with the lower FLI group, the odds of HTN were greater in the intermediate (odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.17-2.14, P = 0.003) and higher groups (OR: 2.59, 95% CI: 1.79-3.76, P < 0.001). Results were consistent in a sensitivity model treating FLI as continuous, each 10-unit increase in FLI was associated with 15.6% higher odds of HTN (OR: 1.16, 95% CI: 1.10-1.22, P < 0.001). Thus, FLI may serve as a valuable diagnostic indicator of HTN in patients undergoing CCTA, and incorporation of FLI assessment into routine CCTA evaluation protocols should be considered for more comprehensive cardiovascular risk assessment.