{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:59:31Z","timestamp":1774958371871,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The temporal relationship between non\u2010alcoholic fatty liver disease (NAFLD) and hypertension (HTN) remains unclear despite their known association. Using data from the Beijing Health Management Cohort (BHMC) with a 5\u2010year follow\u2010up, we investigated these bidirectional links through Cox proportional hazards regression and a cross\u2010lagged panel model (CLPM), adjusting for confounders. Systolic\/diastolic blood pressure (SBP\/DBP) and hepatic steatosis index (HSI) were treated as continuous variables to enhance biological interpretability. Cox regression revealed that HTN increased the risk of NAFLD (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01\u20131.30, <jats:italic>p<\/jats:italic> &lt;\u00a00.05) among participants without NAFLD at baseline, while NAFLD elevated the risk of HTN (HR: 1.11, 95% CI: 1.02\u20131.21, <jats:italic>p<\/jats:italic> &lt;\u00a00.05) among those without HTN at baseline. However, CLPM involving 7349 participants identified a unidirectional temporal relationship from HTN to NAFLD, regression coefficients <jats:italic>\u03b2<\/jats:italic><jats:sub>SBP2017\u2192HSI2022<\/jats:sub>: 0.036 (95% CI: 0.012, 0.059), <jats:italic>\u03b2<\/jats:italic><jats:sub>DBP2017\u2192HSI2022<\/jats:sub>: \u22120.044 (95% CI: \u22120.068, \u22120.020), both <jats:italic>p<\/jats:italic> &lt;\u00a00.05; but not from NAFLD to HTN, regression coefficients <jats:italic>\u03b2<\/jats:italic><jats:sub>HSI2017\u2192SBP2022<\/jats:sub>: 0.017 (95% CI: \u22120.003,0.037), <jats:italic>\u03b2<\/jats:italic><jats:sub>HSI2017\u2192DBP2022<\/jats:sub>:0.006 (95% CI: \u22120.016,0.028), both <jats:italic>p<\/jats:italic> &gt;\u00a00.05. Overall, our study demonstrates a unidirectional temporal association from HTN to NAFLD. However, a bidirectional relationship was also observed in individuals under 60 years and in those without central obesity. These findings highlight the importance of considering age and central obesity to manage HTN to reduce the risk of future NAFLD and to manage NAFLD to reduce the risk of future HTN.<\/jats:p>","DOI":"10.1111\/jch.70012","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T05:11:13Z","timestamp":1740546673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Directional Temporal Relationship Between Hypertension and Non\u2010Alcoholic Fatty Liver Disease: A Cross\u2010Lagged Cohort Study"],"prefix":"10.1111","volume":"27","author":[{"given":"Jianmin","family":"Tang","sequence":"first","affiliation":[{"name":"School of Public Health Capital Medical University  Beijing China"},{"name":"Beijing Key Laboratory of Clinical Epidemiology  Beijing 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