Common Antihypertensive Drug Classes Are Associated With Better Liver Outcomes in MASLD: CGH | October 2026

What Did the Study Find?

Investigators analysed 4,302 individuals with Metabolic dysfunction-associated steatotic liver disease and hypertension in the international VCTE-Prognosis cohort. Participants were followed for a median of 4.6 years. Researchers compared liver stiffness trajectories and liver-related events among users and non-users of renin–angiotensin system inhibitors (RAS inhibitors) and calcium-channel blockers (CCBs), using adjusted analyses to address measured confounding.

RAS-inhibitor use was associated with a higher likelihood of liver stiffness regression (HR 1.22; 95% CI 1.01–1.47) and a lower hazard of liver-related events (HR 0.43; 95% CI 0.26–0.71). CCB use was associated with less liver stiffness progression (HR 0.68; 95% CI 0.52–0.89) and a lower hazard of liver-related events (HR 0.56; 95% CI 0.33–0.96). Absolute event rates were not provided in the published abstract, so absolute risk reductions and numbers needed to treat cannot be calculated from these results. PubMed

Why Does It Matter?

These findings raise the possibility that antihypertensive drug selection could influence liver outcomes in addition to cardiovascular and renal outcomes. However, this was an observational study, not a randomized comparison; residual confounding and treatment-selection effects remain possible. The findings do not justify switching a well-controlled patient solely to obtain a presumed liver benefit.

GastroAGI Takeaway: When antihypertensive options are otherwise clinically equivalent, these findings support further consideration of RAS inhibitors or CCBs in MASLD—but prospective evidence is needed before recommending either class specifically for liver protection.