MASLD is characterised by liver steatosis accompanied by at least one of five cardiometabolic risk factors, thereby highlighting its association with cardiovascular disease (CVD). Notably, CVD represents the leading cause of mortality in this patient population.
This review aims to present recent research into CVD’s pathophysiology in MASLD, with a particular focus on risk factors and screening strategies for steatotic patients.
Patients with MASLD should undergo screening for CVD risk factors at diagnosis. Subsequent screenings post-diagnosis should be personalised based on the specific CVD risk factors each patient presents with. These are delineated within the SCORE2 scoring system. While not validated for MASLD patients specifically, this system stands out as an effective CVD screening tool for patients without known CVD or metabolic diseases. Additionally, MASLD management should occur via weight loss-inducing lifestyle interventions, which further mitigate CVD risk. Moreover, while statins are recognised as a first-line treatment for hyperlipidaemia in type 2 diabetes, they are underprescribed in MASLD patients. Clinicians should thus consider their use as a second-line treatment for MASLD-associated dyslipidaemia, given the absence of MASLD-specific pharmacotherapies.