The associations of the triglyceride-glucose index and its combination with blood pressure on cardiovascular and all-cause mortality in hypertension: a national study

Front Endocrinol (Lausanne). 2024 Oct 14:15:1469055. doi: 10.3389/fendo.2024.1469055. eCollection 2024.

Abstract

The triglyceride-glucose (TyG) index, a reliable surrogate biomarker of insulin resistance (IR), is highlighted recently as related to cardiac disorders. However, the associations of the TyG index and its combination with blood pressure (BP) on cardiovascular and all-cause mortality in hypertension remain unclear. In this study, we included 9,635 hypertension patients from the National Health and Nutrition Examination Survey 1999-2018. During a median follow-up of 8.00 years, a total number of 853 and 2,489 in cardiovascular and all-cause deaths occurred, respectively. After full adjustments, the individual TyG index was positively associated with cardiovascular and all-cause mortality with J-shaped dose-response relationships. The lowest risk thresholds of the TyG index for cardiovascular and all-cause mortality were 9.5551 and 9.3405, respectively. In joint analyses, the highest risks of cardiovascular and all-cause mortality were observed among those with elevated levels of both BP and IR [1.64 (1.18, 2.28), P = 0.0031; 1.39 (1.14, 1.70), P = 0.0011; respectively]. In sensitivity and subgroup analyses, the results were generally robust. Our data appeal a hypothesis that future treatments for hypertension may require a combination of BP controlled and IR improvement.

Keywords: blood pressure; insulin resistance; joint analyses; mortality; triglyceride-glucose index.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Glucose* / analysis
  • Blood Pressure* / physiology
  • Cardiovascular Diseases* / blood
  • Cardiovascular Diseases* / mortality
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension* / blood
  • Hypertension* / epidemiology
  • Hypertension* / mortality
  • Insulin Resistance
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • Risk Factors
  • Triglycerides* / blood

Substances

  • Triglycerides
  • Blood Glucose
  • Biomarkers

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by the Team for the prevention and treatment of acute myocardial infarction with Chinese medicine (2019KCXTD009 to Min-zhou ZHANG), the Specific Research Fund for TCM Science and Technology of Guangzhou Provincial Hospital of Chinese Medicine (YN10101915), the Research Fund for Zhaoyang Talents of Guangdong Provincial Hospital of Chinese Medicine (No. ZY2022KY03, No. ZY2022KY11), the Guangdong Basic and Applied Basic Research Fund (2021A1515220035), and the SHI Zai-xiang Academic Thought Inheritance Studio (No. 2014-89).