Fatty Liver Disease Can Raise Heart Risk
Fatty liver disease increases the risk of fatal and non-fatal cardiovascular disease. In one nationwide study, people with MASLD had a 36% higher risk of heart failure than people without it.
AI Summary Cardiovascular disease is the leading cause of death in people with fatty liver disease, accounting for about 40% of deaths, and heart failure risk is 36% higher than in people without it.
Cardiovascular ProblemsHow heart and blood vessel disease connects to your liver, and what to do about it
Medically reviewed.
Heart disease and liver disease are closely linked. Fatty liver disease, also called metabolic dysfunction-associated steatotic liver disease (MASLD) or nonalcoholic fatty liver disease (NAFLD), raises the risk of heart attack, stroke, and other cardiovascular disease. Cardiovascular disease is the leading cause of death in people with fatty liver disease. The two conditions share risk factors such as high blood pressure, abnormal cholesterol, and excess weight, and neither one causes clear symptoms early on. That is why people with one condition should be checked for the other.
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About the Connection
How Heart Disease and Liver Disease Are Connected
Cardiovascular disease means disease of the heart and blood vessels, such as clogged arteries, heart attack, stroke, and heart failure. Studies show that fatty liver disease increases the risk of both fatal and non-fatal cardiovascular disease. Cardiovascular disease accounts for about 40% of all deaths in people with MASLD, and people with MASLD have a 36% higher risk of developing heart failure than people without it.
One of the most common explanations is metabolic syndrome. This is a group of conditions, including high blood pressure, high blood sugar, and obesity, that raise the risk of heart disease, stroke, and diabetes. Metabolic syndrome is very common in people with liver disease.
The liver also helps regulate fat and controls how much cholesterol the body makes and removes. When the liver is damaged, changes in how the body handles blood fats, along with blood vessel damage and inflammation throughout the body, can add to heart risk.
Fatty liver disease often causes no symptoms early on. Because of shared risk factors, people with fatty liver disease should be screened for heart conditions, and people with heart conditions should be tested for liver disease.
Know Your Risk
Risk Factors and Warning Signs
Heart disease and fatty liver disease share many risk factors, and both can go unnoticed for years.
Factors That Raise Your Risk
- Metabolic syndrome
- High blood pressure
- High cholesterol or high triglycerides
- Type 2 diabetes or insulin resistance
- Obesity or excess weight
Signs Your Liver May Be Affected
- Often no symptoms in early stages
- Fatigue or general weakness
- Pain in the upper right abdomen
- Abdominal pain and swelling in advanced disease
- Yellowing of the eyes and skin (jaundice) in advanced disease
How the Two Conditions Connect
How Heart Disease and Liver Disease Overlap
The link between heart disease and liver disease is well documented. It shows up in three main ways.
- Shared Metabolic Risk
- Metabolic syndrome combines high blood pressure, high blood sugar, and obesity. It is very common in people with liver disease, and it raises the risk of heart disease, stroke, and diabetes.
- Blood Fats and Inflammation
- The liver regulates fat and controls cholesterol production and removal. In fatty liver disease, changes in how the body handles blood fats, damage to the lining of blood vessels (endothelial dysfunction), and inflammation throughout the body all raise cardiovascular risk.
- Early Artery Changes
- People with fatty liver disease often show early signs of artery disease, such as thickening of the neck (carotid) artery walls and calcium deposits in the aorta. These changes often appear regardless of how long someone has had diabetes or how well their blood sugar is controlled.
Why This Matters
Because the two conditions share causes and can affect each other, heart screening is recommended for everyone with fatty liver disease. At a minimum, this means a detailed review of your cardiovascular risk factors.
The Connection in Both Directions
A Two-Way Street Between the Heart and the Liver
Heart Risk Factors Can Worsen Liver Disease
Heart and metabolic risk factors can also speed up liver damage. High blood pressure can double the rate of fibrosis progression, so people with fibrosis and high blood pressure need closer monitoring. Too much sodium may also harm liver cells and lead to scarring. Keeping blood pressure and cholesterol in a healthy range helps protect both organs.
What Raises Your Risk for Both Conditions
Weight, metabolism, and lifestyle factors that damage the heart often harm the liver too, and they tend to reinforce one another.
Shared Metabolic Risk Factors
- Obesity or excess weight, especially around the waist
- High blood pressure
- High cholesterol and high triglycerides
- Type 2 diabetes, insulin resistance, and high blood sugar
Lifestyle and Other Contributing Factors
- A diet high in fat, refined carbohydrates, sugary drinks, and processed foods
- Low physical activity
- Too much sodium (salt)
- Certain prescription medicines, including some heart medicines such as amiodarone and diltiazem, which can cause fat buildup in the liver
Manage the Whole Picture, Not Just One Condition
Treating weight, blood pressure, cholesterol, and blood sugar together gives you the best chance of protecting your heart and liver at the same time. Always ask your doctor before you stop or change any medicine.
Taking Action
Protecting Your Heart and Liver Together
Get Screened for Both Conditions
Ask your doctor for a heart risk assessment if you have fatty liver disease, and ask about liver testing if you have heart disease. Liver blood tests and imaging can catch liver problems before symptoms appear.
Manage Your Weight and Stay Active
If you are overweight, aim for gradual weight loss of 5% to 10% of your body weight. Regular exercise helps you control your weight, raises "good" HDL cholesterol, and lowers triglycerides and "bad" LDL cholesterol. Exercise can reduce liver fat even without weight loss.
Move at a Moderate Pace
Build up slowly toward 150 minutes of moderate activity each week, such as brisk walking, biking, or water aerobics. Aerobic exercise is good for your cardiovascular system, and resistance training adds muscle strength and metabolic benefit.
Control Your Risk Factors
Control blood pressure, cholesterol, and blood sugar, and limit alcohol and sugary, high-fat, processed foods. Talk with your doctor about your treatment plan, and always ask before you start or stop any medicine.
Heart-Healthy Eating
What to Eat to Protect Your Heart and Liver
A cardiac diet, also called a heart-healthy diet, mirrors a liver-healthy diet. It is low in cholesterol, saturated fat, trans fats, and sodium, and it is built around whole grains, lean poultry, fish, vegetables, and fruits. It can help lower blood cholesterol and your risk of heart attack and stroke, and it can support your liver.
Limit foods that raise cholesterol and blood pressure. Trans fats, found in coffee creamers, margarine, and frozen pizza, should be avoided. Saturated fats, found in high-fat meat and dairy and in coconut and palm oils, should be limited. Too much sodium makes your body hold water, which makes your heart and blood vessels work harder and can raise your blood pressure. Cooking at home helps you control the fat and salt in your food.
A Mediterranean-style eating pattern, rich in vegetables, whole grains, legumes, olive oil, and fish, is also commonly recommended for people with fatty liver disease. Ask your care team which plan fits your condition and stage.
Foods to Build Your Plate Around
- Whole grains, such as brown rice, oats, quinoa, and whole wheat bread
- Vegetables and fruits
- Lean poultry and fish, with skin removed from poultry
- Healthy unsaturated fats, such as olive oil, nuts, and seeds
- Herbs and spices in place of salt
Common Questions
Frequently Asked Questions
Does liver disease increase the risk of heart disease?
Yes. Fatty liver disease increases the risk of both fatal and non-fatal cardiovascular disease, and cardiovascular disease is the leading cause of death in people with it. It accounts for about 40% of deaths in people with MASLD. People with MASLD also have a 36% higher risk of developing heart failure than people without it. Shared risk factors, such as high blood pressure, abnormal cholesterol, and excess weight, drive much of this link.
Should I get my heart checked if I have fatty liver disease?
Yes. Experts recommend heart screening for everyone with fatty liver disease, even if you feel fine. At a minimum, this means a detailed review of your cardiovascular risk factors, such as blood pressure, cholesterol, blood sugar, and weight. Heart disease is often the bigger threat, and it can show up before liver disease becomes life-threatening. Ask your doctor what kind of heart assessment is right for you.
Should I get my liver checked if I have heart disease?
Yes. Because the two conditions share risk factors, people with heart conditions should be tested for liver disease. Fatty liver disease often causes no symptoms early on, so you can have it without knowing. Liver blood tests and imaging can find liver problems before symptoms appear. Ask your doctor whether liver testing makes sense for you, especially if you also have obesity, type 2 diabetes, or abnormal cholesterol.
Why are heart problems so common in fatty liver disease?
Metabolic syndrome is one of the most common explanations. It is a group of conditions, including high blood pressure, high blood sugar, and obesity, that raise the risk of heart disease, stroke, and diabetes. It is very common in people with liver disease. The liver also helps regulate fat and controls how much cholesterol the body makes and removes. When the liver is damaged, changes in blood fats, damage to the lining of blood vessels, and inflammation throughout the body can add to heart risk. Many people with fatty liver disease also show early artery changes, such as thickened neck arteries and calcium deposits in the aorta.
Can high blood pressure make liver disease worse?
Yes. High blood pressure can double the rate of fibrosis progression, which is the buildup of scar tissue in the liver. That is why people with fibrosis and high blood pressure need closer monitoring. Too much sodium may also lower liver cell division, misshape liver cells, and increase liver cell death, which can lead to scarring. Keeping your blood pressure in a healthy range helps protect both your heart and your liver.
How can I check my blood pressure at home?
A digital upper-arm monitor is an easy way to track your blood pressure at home. Measure at consistent times and under similar conditions, and write your readings in a journal or app to share with your doctor. A normal reading is below 120 over 80. Stage 1 high blood pressure starts at 130 over 80, and stage 2 starts at 140 over 90. A reading above 180 over 120 is a hypertensive crisis, and you should seek emergency care. Talk with your doctor promptly if your readings stay high or low.
What diet helps both my heart and my liver?
A heart-healthy diet, also called a cardiac diet, is a good choice because it mirrors a liver-healthy diet. It is low in cholesterol, saturated fat, trans fats, and sodium, and it is built around whole grains, vegetables, fruits, lean poultry, and fish. A typical cardiac diet limits cholesterol to 300 milligrams or less per day and sodium to less than 2,000 milligrams per day. Cooking at home and using herbs and spices instead of salt make this easier. A Mediterranean-style pattern is also commonly recommended for fatty liver disease. Regular exercise and gradual weight loss help both organs, so ask your care team which plan fits you.
Medical disclaimer: LiverDirectory provides educational information and a directory of providers. It does not provide medical advice, diagnosis, or treatment. Always consult a licensed physician regarding any medical condition.