Arterial hypertension as a comorbidity of cirrhosis

Liver cirrhosis (LC) and arterial hypertension (AH) are chronic diseases largely diffused worldwide [ [1] Moon A.M. Singal A.G. Tapper E.B. Contemporary epidemiology of chronic liver disease and cirrhosis. Clin Gastroenterol Hepatol. 2020; 18: 2650-2666 Abstract Full Text Full Text PDF PubMed Scopus (423) Google Scholar , [2] Williams B. Mancia G. Spiering W. et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39: 3021-3104 Crossref PubMed Scopus (5922) Google Scholar . Both diseases mostly occur in adulthood and become symptomatic and seriously impacting on survival of patients when clinical complications appear. Indeed, portal hypertension (PH) is the driver of the complications [i.e., ascites, gastro-intestinal (GI) bleeding, hepatic encephalopathy (HE)] transforming a compensated (asymptomatic) to a decompensated (symptomatic and life threatening) cirrhosis, whereas the generalized involvement of the arterial system occurring in AH is a main risk factor for all cardio-vascular diseases [ [3] Oparil S. Acelajado M.C. Bakris G.L. et al. Hypertension. Nat Rev Dis Prim. 2018; 4: 18014 Crossref PubMed Scopus (545) Google Scholar , [4] Bernardi M. Moreau R. Angeli P. Schnabl B. Arroyo V. Mechanisms of decompensation and organ failure in cirrhosis: from peripheral arterial vasodilation to systemic inflammation hypothesis. J Hepatol. 2015; 63: 1272-1284 Abstract Full Text Full Text PDF PubMed Scopus (403) Google Scholar .