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. 2023 Nov 9;22(1):311.
doi: 10.1186/s12933-023-02038-5.

Association between insulin resistance and uncontrolled hypertension and arterial stiffness among US adults: a population-based study

Liao Tan #  1 , Yubo Liu #  2 , Jie Liu  2 , Guogang Zhang  1   2 , Zhaoya Liu  3 , Ruizheng Shi  4
Affiliations

Association between insulin resistance and uncontrolled hypertension and arterial stiffness among US adults: a population-based study

Liao Tan et al. Cardiovasc Diabetol. .

Abstract

Background: Prior research has established the correlation between insulin resistance (IR) and hypertension. While the association between triglyceride-glucose (TyG) index, a reliable surrogate marker of IR, and uncontrolled hypertension as well as arterial stiffness among individuals with hypertension remains undisclosed.

Methods: In this study, a total of 8513 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey 1999-2018 were included. The primary outcome of the study are arterial stiffness (represented with estimated pulse wave velocity, ePWV) and uncontrolled hypertension. Logistic regression model, subgroup analysis, restricted cubic spine, and smooth curve fitting curve were conducted to evaluate the association between the IR indicators and uncontrolled hypertension and arterial stiffness in individuals with hypertension.

Results: Among included participants, the overall prevalence of uncontrolled hypertension was 54.3%. After adjusting for all potential covariates, compared with the first quartile of TyG index, the risk of uncontrolled hypertension increased about 28% and 49% for participants in the third quartile (OR, 1.28; 95% CI 1.06-1.52) and the fourth quartile (OR, 1.49; 95% CI 1.21-1.89) of TyG index, respectively. The higher OR of TyG index was observed in participants taking antihypertensive medication [fourth quartile versus first quartile (OR, 2.03; 95% CI 1.37-3.11)]. Meanwhile, we explored the potential association between TyG index and arterial stiffness and found that TyG index was significantly associated with increased arterial stiffness (β for ePWV, 0.04; 95% CI 0.00-0.08; P = 0.039). However, traditional IR indicator HOMA-IR showed no significant positive correlation to uncontrolled hypertension as well as arterial stiffness in US adults with hypertension.

Conclusion: Elevated levels of the TyG index were positive associated with prevalence of uncontrolled hypertension and arterial stiffness among US adults with hypertension.

Keywords: Arterial stiffness; Hypertension; Insulin resistance; NHANES; Triglyceride-glucose index.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Flowchart of study population
Fig. 2
Fig. 2
The restricted cubic spline of TyG index and the incidence of uncontrolled hypertension. Plane (a): total hypertensive participants; Plane (b): hypertensive participants with anti-hypertensive medication; Plane (c): hypertensive participants without anti-hypertensive medication. The horizontal solid line represents the logOR = 0. The black curve shows the value of logOR. The grey shaded area represents the 95 CI. Adjusted for age, sex, ethnicity, education, BMI, smoking status, alcohol consumption, diabetes, hyperlipidemia, cardiovascular disease, chronic kidney disease, anti-hypertensive agents, anti-diabetic agents, and anti-hyperlipidemia agents
Fig. 3
Fig. 3
Subgroup analyses for the association of TyG index and uncontrolled hypertension. Adjusted for age, sex, ethnicity, education, BMI, smoking status, alcohol consumption, diabetes, hyperlipidemia, cardiovascular disease, chronic kidney disease, anti-hypertensive agents, anti-diabetic agents, anti-hyperlipidemia agents other than variables for stratification
See this image and copyright information in PMC

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