Association of the Triglyceride-Glucose Index With Resistant Hypertension and a Nomogram Model Construction

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2024 Sep 18

PMID 39291489

Authors

Hai-Tao Yang

Jing-Kun Liu

Bang-Quan Liu

Yi Yang

Xiang Xie

Affiliations

Soon will be listed here.

Abstract

Background: Resistant hypertension (RH) remains one of the major risk factors for cardiovascular disease. This study aims to investigate the association between the triglyceride-glucose (TyG) index and RH incidence in patients with hypertension and to construct a nomogram for predicting the occurrence of RH.

Methods And Results: A retrospective cohort study was conducted on 1635 patients initially diagnosed with hypertension at the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from August 2019 to August 2021. Patients were followed up for a median of 31 months, with 373 cases (22.81%) developing RH. Least absolute shrinkage and selection operator regression and multivariable Cox regression analysis identified the TyG index as the strongest predictor of RH (hazard ratio, 5.472 [95% CI, 4.028-7.433]; <0.001). Consistent results were also observed in subgroup analyses across different ages and sexes. In addition to the TyG index, other independent risk factors, including uric acid, age, and the apnea-hypopnea index, were noted. A nomogram model was subsequently developed using these risk factors, and including the TyG index notably enhanced the diagnostic effectiveness of the model in predicting the occurrence of RH.

Conclusions: The TyG index appears to be a potential predictor of RH in patients with hypertension, indicating that insulin resistance might be an important factor in the development and progression of RH.

References

Mogi M, Tanaka A, Node K, Tomitani N, Hoshide S, Narita K . 2023 update and perspectives. Hypertens Res. 2023; 47(1):6-32. DOI: 10.1038/s41440-023-01398-5. View

Nagarathinam A, Nanda N, Pal G, Sahoo J . Relationship between Insulin Resistances with Autonomic Functions in Patients with Type 2 Diabetes in South Indian Population. Mymensingh Med J. 2022; 31(4):1135-1141. View

Tian Z, Barbosa C, Lang H, Bauersachs J, Melk A, Schmidt B . Efficacy of pharmacological and interventional treatment for resistant hypertension: a network meta-analysis. Cardiovasc Res. 2023; 120(1):108-119. DOI: 10.1093/cvr/cvad165. View

Pang J, Qian L, Che X, Lv P, Xu Q . TyG index is a predictor of all-cause mortality during the long-term follow-up in middle-aged and elderly with hypertension. Clin Exp Hypertens. 2023; 45(1):2272581. DOI: 10.1080/10641963.2023.2272581. View

Eirin A, Textor S, Lerman L . Emerging concepts for patients with treatment-resistant hypertension. Trends Cardiovasc Med. 2016; 26(8):700-706. PMC: 5065380. DOI: 10.1016/j.tcm.2016.05.004. View

Deng X, Hou H, Wang X, Li Q, Li X, Yang Z . Development and validation of a nomogram to better predict hypertension based on a 10-year retrospective cohort study in China. Elife. 2021; 10. PMC: 8163499. DOI: 10.7554/eLife.66419. View

Yugar-Toledo J, Brunelli V, Vilela-Martin J, Fattori A, Moreno H . Controlled Versus Uncontrolled Resistant Hypertension: Are They in the Same Bag?. Curr Hypertens Rep. 2018; 20(3):26. DOI: 10.1007/s11906-018-0825-7. View

Oliveri A, Rebernick R, Kuppa A, Pant A, Chen Y, Du X . Comprehensive genetic study of the insulin resistance marker TG:HDL-C in the UK Biobank. Nat Genet. 2024; 56(2):212-221. PMC: 10923176. DOI: 10.1038/s41588-023-01625-2. View

Moran A, Gupta R . Implementation of Global Hearts Hypertension Control Programs in 32 Low- and Middle-Income Countries: JACC International. J Am Coll Cardiol. 2023; 82(19):1868-1884. DOI: 10.1016/j.jacc.2023.08.043. View

10.

Chaudhary S, Gupta P, Sawlani K, Gupta K, Singh A, Usman K . Obstructive Sleep Apnea in Hypertension. Cureus. 2023; 15(4):e38229. PMC: 10225023. DOI: 10.7759/cureus.38229. View

11.

Sun H, Chang X, Bian N, An Y, Liu J, Leng S . Adipose Tissue Insulin Resistance Is Positively Associated With Serum Uric Acid Levels and Hyperuricemia in Northern Chinese Adults. Front Endocrinol (Lausanne). 2022; 13:835154. PMC: 9226335. DOI: 10.3389/fendo.2022.835154. View

12.

Cheng L, Zhang F, Xue W, Yu P, Wang X, Wang H . Association of dynamic change of triglyceride-glucose index during hospital stay with all-cause mortality in critically ill patients: a retrospective cohort study from MIMIC IV2.0. Cardiovasc Diabetol. 2023; 22(1):142. PMC: 10276426. DOI: 10.1186/s12933-023-01874-9. View

13.

Khan S, Sobia F, Niazi N, Manzoor S, Fazal N, Ahmad F . Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance. Diabetol Metab Syndr. 2018; 10:74. PMC: 6173832. DOI: 10.1186/s13098-018-0376-8. View

14.

Walli-Attaei M, Joseph P, Johansson I, Sliwa K, Lonn E, Maggioni A . Characteristics, management, and outcomes in women and men with congestive heart failure in 40 countries at different economic levels: an analysis from the Global Congestive Heart Failure (G-CHF) registry. Lancet Glob Health. 2024; 12(3):e396-e405. DOI: 10.1016/S2214-109X(23)00557-0. View

15.

Haring B, Schumacher H, Mancia G, Teo K, Lonn E, Mahfoud F . Triglyceride-glucose index, low-density lipoprotein levels, and cardiovascular outcomes in chronic stable cardiovascular disease: results from the ONTARGET and TRANSCEND trials. Eur J Prev Cardiol. 2023; 31(3):311-319. DOI: 10.1093/eurjpc/zwad340. View

16.

Yahr J, Thomas G, Calle J, Taliercio J . Resistant hypertension: A stepwise approach. Cleve Clin J Med. 2023; 90(2):115-125. DOI: 10.3949/ccjm.90a.22046. View

17.

Li J, Dong Z, Wu H, Liu Y, Chen Y, Li S . The triglyceride-glucose index is associated with atherosclerosis in patients with symptomatic coronary artery disease, regardless of diabetes mellitus and hyperlipidaemia. Cardiovasc Diabetol. 2023; 22(1):224. PMC: 10463708. DOI: 10.1186/s12933-023-01919-z. View

18.

Liang J, Zhao Y, Chen Y, Huang S, Zhang S, Jiang N . Development and Validation of a Nomogram-Based Prognostic Model to Predict High Blood Pressure in Children and Adolescents-Findings From 342,736 Individuals in China. Front Cardiovasc Med. 2022; 9:884508. PMC: 9260112. DOI: 10.3389/fcvm.2022.884508. View

19.

Volpe M, Gallo G, Battistoni A, Tocci G . Highlights of ESC/ESH 2018 Guidelines on the Management of Hypertension: What Every Doctor Should Know. High Blood Press Cardiovasc Prev. 2019; 26(1):1-8. DOI: 10.1007/s40292-018-00297-y. View

20.

De La Sierra A, Ruilope L, Martinez-Camblor P, Vinyoles E, Gorostidi M, Segura J . Impact of timing of antihypertensive treatment on mortality: an observational study from the Spanish Ambulatory Blood Pressure Monitoring Registry. J Hypertens. 2023; 42(2):260-266. DOI: 10.1097/HJH.0000000000003581. View