Associations of the Triglyceride and Glucose Index with Hypertension Stages, Phenotypes, and Progressions among Middle-aged and Older Chinese

Background The triglyceride and glucose (TyG) index has been proposed as a surrogate indicator of insulin resistance. By far, the associations of the TyG index with hypertension stages, phenotypes, and progressions remain unclear. Methods The data originated from two waves (2011 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS). Participants with systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or using antihypertensive medications were considered hypertensive. After excluding those under antihypertensive medications, hypertension stages were classified as stage 1 and stage 2, and phenotypes were classified as isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH). Multinomial logistic regression was used to investigate the associations of the TyG index with hypertension stages and phenotypes, together with their progressions from 2011 to 2015. Results At baseline in CHARLS 2011, a total of 8,209 participants were recruited, among whom 3,169 (38.6%) were hypertension. Compared with individuals with the lowest quartile (Q1) of TyG index, those with the highest quartile (Q4) were significantly associated with increased risks of stage 1 hypertension (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.38-2.13), stage 2 hypertension (1.74, 1.27-2.38), ISH (1.66, 1.31-2.11), IDH (2.52, 1.26-5.05), and SDH (1.65, 1.23-2.23). Similar results were found when the TyG index was used as a continuous variable. From 2011 to 2015, a higher baseline TyG index was revealed to be significantly associated with the progressions from normotension to stage 1 (for Q4 vs Q1: 1.45, 1.05-2.00; for per-unit: 1.39, 1.16-1.65), normotension to ISH (for per-unit: 1.28, 1.04-1.56), and normotension to IDH (for Q4 vs Q1: 3.46, 1.42-8.44; for per-unit: 1.94, 1.27-2.97). Conclusions The TyG index was significantly associated with different hypertension stages, phenotypes and their progressions. Our findings highlight the importance of the TyG index as a potential surrogate indicator for early hypertension screening and management. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: http://charls.pku.edu.cn/ I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The dataset presented in this study can be found in online repositories.