Targeting TyG index more effective for primary and secondary prevention of hypertension, study suggests

Hui Zhao, Health Management Center of the Second Affiliated Hospital of Dalian Medical University, Shahekou District, Dalian, Liaoning, China, and colleagues showed that elevated triglyceride glucose index at baseline and long-term trajectories of TyG index were associated with hypertension risk.

Previous studies have demonstrated that TyG index trajectories are associated with cardiovascular diseases (CVDs). However, no investigation has been performed on the association between the patterns of TyG index trajectories and hypertension risk. The research team, therefore, aimed to identify distinct TyG index trajectories over 12 years and describe their association with the incidence of hypertension in a longitudinal general population.

For this purpose, they retrospectively recruited 15,056 adults from the Physical Examination Center of the Second Affiliated Hospital of Dalian Medical University in the northeast of China. The median age of the population was 38 years, and 48.83% of the participants were men.

TyG index was calculated as ln (fasting TG [mg/dL] × FPG [mg/dL]/2) and the TyG index trajectories were developed using group-based trajectory modelling. The association between the TyG index and the incidence of hypertension was assessed using the Cox regression analysis.

The researchers reported the following findings:

• Three distinct TyG index trajectories were identified: “low increasing” (N = 7241), “moderate increasing” (N = 6448), and “high stable” (N = 1367).
• Using the “low increasing” trajectory as a reference, “moderate increasing” and “high stable” trajectories were associated with an increased risk of hypertension (HR = 2.45 and HR = 3.88).
• After adjusting for baseline age, sex, smoking, diabetes, systolic blood pressure, diastolic blood pressure, cholesterol, BMI, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood glucose, triglyceride, uric acid, urea and glomerular filtration rate, the HR were slightly attenuate in “moderate increasing” and “high stable” trajectories to 1.38 and 1.69 respectively. Similar results were observed in multiple sensitivity analyses.
• The HR of the “moderate increasing” and “high stable” trajectory groups were 2.63 and 4.66 in females and 1.66 and 2.33 in males.

"Our findings indicate that not only the baseline TyG index but also high TyG index growth trajectories were associated with hypertension development," the researchers wrote. "Long-term monitoring of dynamic changes of the TyG index may identify people at high hypertension risk."

"Prevention programs that target the TyG index may be more effective for primary and secondary prevention of hypertension," they concluded.

Reference:

Xin, F., He, S., Zhou, Y. et al. The triglyceride glucose index trajectory is associated with hypertension: a retrospective longitudinal cohort study. Cardiovasc Diabetol 22, 347 (2023). https://doi.org/10.1186/s12933-023-02087-w