The ‘silent’ disease that causes sudden heart failure… and one in FIVE Brits have it – know the 4 signs

Published on August 26, 2025 at 02:57 PM
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A ‘SILENT’ liver disease that affects millions of Brits could secretly be wrecking your heart – with one in five people at risk.

The disease, known as MASLD (metabolic dysfunction-associated steatotic liver disease), doesn’t just damage the liver , new research from Duke University in the US has revealed.

Illustration of a human liver within the torso.
Having fatty liver disease can increase the risk of heart failure

The condition, also called non alcoholic fatty liver disease , could also leave the heart dangerously weak, even if you feel fine.

For the research, doctors tracked 570 people with MASLD for up to 11 years.

They found that almost half had early signs of heart failure despite never being diagnosed with a heart condition.

Around a fifth went on to develop full heart failure during the study, yet, only five per cent had ever actually been told they had the condition.

Heart failure is a chronic condition where the heart can’t pump enough blood to meet the body’s needs, often because the heart muscle is too weak or stiff.

In the UK, it’s thought up to one in five adults has MASLD, according to the British Liver Trust.

While it’s most common in people who are overweight or have diabetes , it can also strike people of a healthy weight.

The problem starts when the body can’t properly handle fats and sugars, which causes fat to pile up in the liver.

Over time, this fat triggers inflammation and scarring that slowly damages the organ.

The danger is that in the early stages you can have a fatty, scarred liver and still feel completely well.

It has no specific cure and may cause  cancer  in later life.

That means the disease can creep along silently for years or even decades, only becoming obvious once the liver is badly scarred, and by then the risk of heart failure is much higher

The latest research, published in the  European Journal of Heart Failure in June, found MASLD quietly scars the liver until it struggles to filter toxins – and as the damage builds, the heart grows weaker and prone to failure.

Dr Marat Fudim, who worked on the study, said: “There is a critical gap in recognising heart failure in this high-risk group.”

Dr Kara Wegermann, lead author of the study, added: “There is a real opportunity to screen people earlier and even prevent symptomatic heart failure.”

Holographic illustration of a human heart and circulatory system.
Heart failure is caused by damage to the heart or a problem with the way it works

The 4 warning signs of heart failure

Heart failure is when the heart isn’t able to pump enough blood to meet the body’s needs.

If left untreated, heart failure can worsen over time and become life-threatening.

Signs to look out for include:

  1. Shortness of breath
  2. Swelling in legs, ankles or feet
  3. Racing or irregular heartbeat
  4. Dizziness or fainting

For years, heart failure risk has been tied to  obesity  and body mass index ( BMI ), the standard calculation used by the NHS that compares your weight and height to assess your health.

But now, scientists say your waist-to-height ratio ( WtHR ) could be a better measure and a more accurate way to predict your risk.

“Ideally, your waist should be less than half your height. For example, someone who is 5ft 8in (173cm) should keep their waist under 34in (86cm) to stay in the healthy range.”

Older people are at the highest risk – especially if they also have high blood pressure , high cholesterol , or diabetes , are also most at risk.

What the stages of non-alcoholic fatty liver disease?

THERE are several stages of NAFLD.

Having one stage does not mean you will definitely develop the next one.

Treating NAFLD with a healthy diet, physical activity and weight loss can slow or even reverse it, especially if it is at an earlier stage.

The amount of scarring (fibrosis) in your liver is the main sign of how advanced your NAFLD is. Go to the section about fibrosis tests and scores.

  • Fatty liver: There is a build-up of fat in your liver but it has not been damaged and there is no scarring. At this point, NAFLD can be fully reversed.
  • Non-alcohol related steatohepatitis (NASH) with mild fibrosis : Fat is causing inflammation and damage in your liver (hepatitis). There is no or very little scarring. Healthy living can undo the damage and reverse your NAFLD.
  • NASH with moderate fibrosis: Inflammation and damage have caused some scarring. Your liver is probably still working well and the damage can mostly be repaired.
  • NASH with advanced fibrosis: There is a lot of scarring. At this stage it is very important to stop further damage and scarring so your NAFLD doesn’t get worse. And it is still possible to repair some damage.
  • Cirrhosis: There is so much scarring it changes the shape of your liver. Your liver can keep working and even repair some damage at this point. But if too much of it becomes scarred, your liver may not be able to carry out its job properly.

Cirrhosis can lead to life-threatening conditions including liver cancer and liver failure.

Source:  The British Liver Trust

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