Hypertension promotes endothelial dysfunction, arterial stiffness, and activation of the renin–angiotensin–aldosterone system, which could interact with hepatic lipid accumulation to exacerbate cardiovascular and renal outcomes.[42,43] Collectively, these findings suggest that the interplay between metabolic stress, hormonal environment, and vascular health modulates the strength of the FLI–CKM association across subgroups. This evidence concerns the gene REN and endothelial dysfunction.