Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
  • Published:

The association of triglyceride-glucose index and related parameters with hypertension and cardiovascular risk: a cross-sectional study

Hypertension Research volume 47, pages 877–886 (2024)Cite this article

Abstract

The objective of this study was to investigate the association between triglyceride-glucose index (TyG) and related parameters (TyG-BMI, TyG-WC, TyG-WHR, and TyG-WHtR) with hypertension and cardiovascular risk. Additionally, the study aimed to compare the performance of these parameters in identifying patients with hypertension and high cardiovascular risk and determine appropriate indicators for the prediction of cardiovascular risk. Residents from a community in Beijing, China, who underwent health examinations at a regional hospital between December 2011 and August 2012, were recruited. Logistic regression analysis was used to explore the association between each parameter with hypertension and cardiovascular disease (CVD). The receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension or high cardiovascular risk. A total of 16,834 participants were included. After adjusting for confounders, the highest quartile groups of TyG and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups. Among the parameters, TyG-WC exhibited the highest diagnostic efficacy for hypertension [area under the curve (AUC): 0.665, 95% CI: 0.656–0.673] followed by TyG-WHtR, TyG-BMI, TyG-WHR, and TyG index. Similarly, the highest quartile groups of each parameter demonstrated significantly increased risks of high cardiovascular risk compared to the lowest quartile groups. TyG-WHR performed best in distinguishing participants with high cardiovascular risk (AUC: 0.718, 95% CI: 0.710–0.726) followed by TyG-WC, TyG-WHtR, TyG-BMI, and TyG index. In conclusion, TyG-related parameters had independent associations with hypertension and cardiovascular risk. TyG-WHR exhibited the highest efficacy in distinguishing participants with high cardiovascular risk, which might contribute to the primary prevention of CVD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. NCD Risk Factor Collaboration. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398:957–80.

    Article  Google Scholar 

  2. Zhang M, Wu J, Zhang X, Hu CH, Zhao ZP, Li C, et al. Prevalence and control of hypertension in adults in China, 2018. Zhonghua Liu Xing Bing Xue Za Zhi. 2021;42:1780-9.

  3. Writing committee of the report on cardiovascular health and diseases in China. Report on cardiovascular health and diseases in China 2021: an updated summary. Biomed Environ Sci. 2022;35:573–603.

    Google Scholar 

  4. Zhang Y, Miao H, Chia YC, Buranakitjaroen P, Siddique S, Shin J, et al. Cardiovascular risk assessment tools in Asia. J Clin Hypertens. 2022;24:369–77.

    Article  Google Scholar 

  5. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6:299–304.

    Article  PubMed  Google Scholar 

  6. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95:3347–51.

    Article  CAS  PubMed  Google Scholar 

  7. Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: the Vascular-Metabolic CUN cohort. Prev Med. 2016;86:99–105.

    Article  PubMed  Google Scholar 

  8. Zhang F, Zhang Y, Guo Z, Yang H, Ren M, Xing X, et al. The association of triglyceride and glucose index, and triglyceride to high-density lipoprotein cholesterol ratio with prehypertension and hypertension in normoglycemic subjects: A large cross-sectional population study. J Clin Hypertens. 2021;23:1405–12.

    Article  CAS  Google Scholar 

  9. Moon S, Park JS, Ahn Y. The cut-off values of triglycerides and glucose index for metabolic syndrome in American and Korean Adolescents. J Korean Med Sci. 2017;32:427–33.

    Article  PubMed  Google Scholar 

  10. Sánchez-Íñigo L, Navarro-González D, Fernández-Montero A, Pastrana-Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. Eur J Clin Investig. 2016;46:189–97.

    Article  Google Scholar 

  11. Lee SB, Ahn CW, Lee BK, Kang S, Nam JS, You JH, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018;17:41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Zhang Y, Ding X, Hua B, Liu Q, Gao H, Chen H, et al. High triglyceride-glucose index is associated with poor cardiovascular outcomes in nondiabetic patients with ACS with LDL-C below 1.8 mmol/L. J Atheroscler Thromb. 2022;29:268–81.

    Article  CAS  PubMed  Google Scholar 

  13. Xu L, Wu M, Chen S, Yang Y, Wang Y, Wu S, et al. Triglyceride-glucose index associates with incident heart failure: a cohort study. Diabetes Metab. 2022;48:101365.

    Article  CAS  PubMed  Google Scholar 

  14. Mirshafiei H, Darroudi S, Ghayour-Mobarhan M, Esmaeili H, AkbariRad M, Mouhebati M, et al. Altered triglyceride glucose index and fasted serum triglyceride high-density lipoprotein cholesterol ratio predict incidence of cardiovascular disease in the Mashhad cohort study. Biofactors. 2022;48:643–50.

    Article  CAS  PubMed  Google Scholar 

  15. Lim J, Kim J, Koo SH, Kwon GC. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: an analysis of the 2007–10 Korean National Health and Nutrition Examination Survey. PLoS One. 2019;14:e0212963.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Bala C, Gheorghe-Fronea O, Pop D, Pop C, Caloian B, Comsa H, et al. The association between six surrogate insulin resistance indexes and hypertension: a population-based study. Metab Syndr Relat Disord. 2019;17:328–33.

    Article  CAS  PubMed  Google Scholar 

  17. Yuan Y, Sun W, Kong X. Comparison between distinct insulin resistance indices in measuring the development of hypertension: The China Health and Nutrition Survey. Front Cardiovasc Med. 2022;9:912197.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Song B, Zhao X, Yao T, Lu W, Zhang H, Liu T, et al. Triglyceride glucose-body mass index and risk of incident type 2 diabetes mellitus in Japanese people with normal glycemic level: a population-based longitudinal cohort study. Front Endocrinol. 2022;13:907973.

    Article  Google Scholar 

  19. Raimi TH, Dele-Ojo BF, Dada SA, Fadare JO, Ajayi DD, Ajayi EA, et al. Triglyceride-glucose index and related parameters predicted metabolic syndrome in Nigerians. Metab Syndr Relat Disord. 2021;19:76–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Huang YC, Huang JC, Lin CI, Chien HH, Lin YY, Wang CL, et al. Comparison of innovative and traditional cardiometabolic indices in estimating atherosclerotic cardiovascular disease risk in adults. Diagnostics. 2021;11:603.

  21. Joint Committee for Guideline Revision. 2018 Chinese Guidelines for Prevention and Treatment of Hypertension—a report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of Hypertension. J Geriatr Cardiol. 2019;16:182–241.

    PubMed Central  Google Scholar 

  22. Yang X, Li J, Hu D, Chen J, Li Y, Huang J, et al. Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population: the China-PAR project (Prediction for ASCVD Risk in China). Circulation. 2016;134:1430–40.

    Article  PubMed  Google Scholar 

  23. Zhiting G, Jiaying T, Haiying H, Yuping Z, Qunfei Y, Jingfen J. Cardiovascular disease risk prediction models in the Chinese population- a systematic review and meta-analysis. BMC Public Health. 2022;22:1608.

    Article  PubMed  PubMed Central  Google Scholar 

  24. He P, Fan F, Chen C, Liu B, Jia J, Sun P, et al. Predictive value of 10-year atherosclerotic cardiovascular disease risk equations from the China-PAR for new-onset lower extremity peripheral artery disease. Front Cardiovasc Med. 2022;9:933054.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zhang Y, Zhao Q, Ng N, Wang W, Wang N, Qiu Y, et al. Prediction of 10-year atherosclerotic cardiovascular disease risk among community residents in Shanghai, China - a comparative analysis of risk algorithms. Nutr Metab Cardiovasc Dis. 2021;31:2058–67.

    Article  PubMed  Google Scholar 

  26. Arauz-Pacheco C, Lender D, Snell PG, Huet B, Ramirez LC, Breen L, et al. Relationship between insulin sensitivity, hyperinsulinemia, and insulin-mediated sympathetic activation in normotensive and hypertensive subjects. Am J Hypertens. 1996;9:1172–8.

    Article  CAS  PubMed  Google Scholar 

  27. Cooper SA, Whaley-Connell A, Habibi J, Wei Y, Lastra G, Manrique C, et al. Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance. Am J Physiol Heart Circ Physiol. 2007;293:H2009–23.

    Article  CAS  PubMed  Google Scholar 

  28. Frank HJ, Levin ER, Hu RM, Pedram A. Insulin stimulates endothelin binding and action on cultured vascular smooth muscle cells. Endocrinology. 1993;133:1092–7.

    Article  CAS  PubMed  Google Scholar 

  29. Axelrod L. Insulin, prostaglandins, and the pathogenesis of hypertension. Diabetes. 1991;40:1223–7.

    Article  CAS  PubMed  Google Scholar 

  30. Zheng R, Mao Y. Triglyceride and glucose (TyG) index as a predictor of incident hypertension: a 9-year longitudinal population-based study. Lipids Health Dis. 2017;16:175.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zhu B, Wang J, Chen K, Yan W, Wang A, Wang W, et al. A high triglyceride glucose index is more closely associated with hypertension than lipid or glycemic parameters in elderly individuals: a cross-sectional survey from the Reaction Study. Cardiovasc Diabetol. 2020;19:112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Li Y, You A, Tomlinson B, Yue L, Zhao K, Fan H, et al. Insulin resistance surrogates predict hypertension plus hyperuricemia. J Diabetes Investig. 2021;12:2046–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Cheng W, Kong F, Chen S. Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study. Diabetol Metab Syndr. 2022;14:137.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Janus A, Szahidewicz-Krupska E, Mazur G, Doroszko A. Insulin resistance and endothelial dysfunction constitute a common therapeutic target in cardiometabolic disorders. Mediators Inflamm. 2016;2016:3634948.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med. 2020;18:361.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Guo W, Zhu W, Wu J, Li X, Lu J, Qin P, et al. Triglyceride glucose index is associated with arterial stiffness and 10-year cardiovascular disease risk in a Chinese population. Front Cardiovasc Med. 2021;8:585776.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Zhang Y, Ren L, Ren M, Yang H, Li K, Cong H, et al. Correlation between the triglyceride-glucose index and high risk of cardiovascular disease: a cohort study of 102,061 subjects from Tianjin, China. Risk Manag Health Policy. 2021;14:2803–10.

    Article  Google Scholar 

  38. Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health. 2017;17:101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Heart Failure Center, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Huanhuan Miao, Zhanyang Zhou, Shijie Yang & Yuqing Zhang

Authors
  1. Huanhuan Miao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhanyang Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shijie Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuqing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuqing Zhang.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miao, H., Zhou, Z., Yang, S. et al. The association of triglyceride-glucose index and related parameters with hypertension and cardiovascular risk: a cross-sectional study. Hypertens Res 47, 877–886 (2024). https://doi.org/10.1038/s41440-023-01502-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-023-01502-9

Keywords

This article is cited by

Search

Advanced search

Quick links