{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:45:24Z","timestamp":1788817524088,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T00:00:00Z","timestamp":1404518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Singapore SingHealth HMDP"},{"name":"NIH","award":["T32 DK061917"],"award-info":[{"award-number":["T32 DK061917"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Therapeutic options are limited for patients with non\u2010alcoholic fatty liver disease (<jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>). One promising approach is the attenuation of necroinflammation and fibrosis by inhibition of the renin\u2010angiotensin system (<jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content>). We explored whether the risk of fibrosis was associated with the use of commonly used medications in <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> patients with hypertension. Specifically, we sought to determine the association between <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blocking agents and severity of hepatic fibrosis in <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> patients with hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study where clinical information including demographics, anthropometry, medical history, concomitant medication use, biochemical and histological features were ascertained in 290 hypertensive patients with biopsy proven <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> followed at two hepatology outpatient clinics. Stage of hepatic fibrosis was compared in patients with and without <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blocker use. Other risk factors for fibrosis were evaluated from the electronic medical records and patient follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics of hypertensive patients treated with and without <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blockers were similar except for less ballooning (1.02 vs. 1.31, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001) and lower fibrosis stage (1.63 vs. 2.16, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002) in patients on <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blockers On multivariate analysis, advancing age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.04; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.01\u20131.06, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.012) and presence of diabetes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 2.55; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.28\u20135.09, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.008) had an independent positive association, while use of <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blockers (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 0.37; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.21\u20130.65, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001) and statins (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 0.52; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.29\u20130.93, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.029) had a negative association with advanced fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hypertensive patients with <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> on baseline <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blockers had less advanced hepatic fibrosis suggesting a beneficial effect of <jats:styled-content style=\"fixed-case\">RAS<\/jats:styled-content> blockers in <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12611","type":"journal-article","created":{"date-parts":[[2014,6,6]],"date-time":"2014-06-06T10:36:51Z","timestamp":1402051011000},"page":"979-985","source":"Crossref","is-referenced-by-count":95,"title":["Renin\u2010angiotensin system and fibrosis in non\u2010alcoholic fatty liver disease"],"prefix":"10.1111","volume":"35","author":[{"given":"George B","family":"Goh","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Cleveland Clinic 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