Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;13(19):e034136.
doi: 10.1161/JAHA.123.034136. Epub 2024 Sep 18.

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

Hai-Tao Yang  1   2 , Jing-Kun Liu  3 , Bang-Quan Liu  4 , Yi Yang  2   5 , Xiang Xie  2
Affiliations

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

Hai-Tao Yang et al. J Am Heart Assoc. 2024 Oct.

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]; P<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.

Keywords: TyG index; insulin resistance; nomogram; predictive model; resistant hypertension.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Inclusion of newly diagnosed patients with primary hypertension and stable blood pressure after medication treatment.
Establishment of the development cohort (n=1227) and the external validation cohort (n=408). CAD indicates coronary artery disease; and DM, diabetes mellitus.
Figure 2
Figure 2. In the training and validation cohorts, the TyG index's hazard ratio for predicting the risk of developing RH.
Q indicates quartile; Ref, reference; RH, resistant hypertension; and TyG, triglyceride‐glucose.
Figure 3
Figure 3. Demonstrating the nomogram used for predicting resistant hypertension.
AHI indicates apnea‐hypopnea index; UA, uric acid; and TyG, triglyceride‐glucose.
Figure 4
Figure 4. Evaluating the predictive accuracy of the nomogram for resistant hypertension.
Evaluating the predictive accuracy of the nomogram for resistant hypertension in the development (A) and independent validation (B) cohorts. Model 1: TyG index, uric acid, age, and AHI; Model 2: uric acid, age, and AHI. AHI indicates apnea‐hypopnea index; AUC, area under the curve; and TyG, triglyceride‐glucose.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Walli‐Attaei M, Joseph P, Johansson I, Sliwa K, Lonn E, Maggioni AP, Mielniczuk L, Ross H, Karaye K, Hage C, et al. 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:e396–e405. doi: 10.1016/S2214-109X(23)00557-0 - DOI - PubMed
    1. Mogi M, Tanaka A, Node K, Tomitani N, Hoshide S, Narita K, Nozato Y, Katsurada K, Maruhashi T, Higashi Y, et al. 2023 update and perspectives. Hypertens Res. 2024;47:6–32. doi: 10.1038/s41440-023-01398-5 - DOI - PubMed
    1. Parodi R, Brandani L, Romero C, Klein M. Resistant hypertension: diagnosis, evaluation, and treatment practical approach. Eur J Intern Med. 2024;123:23–28. doi: 10.1016/j.ejim.2023.12.026 - DOI - PubMed
    1. Abiodun OO, Anya T, Chukwu JC, Adekanmbi V. Prevalence, risk factors and cardiovascular comorbidities of resistant hypertension among treated hypertensives in a Nigerian population. Glob Heart. 2024;19:17. doi: 10.5334/gh.1296 - DOI - PMC - PubMed
    1. Haring B, Schumacher H, Mancia G, Teo KK, Lonn EM, Mahfoud F, Schmieder R, Mann JFE, Sliwa K, Yusuf S, et al. 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. 2024;31:311–319. doi: 10.1093/eurjpc/zwad340 - DOI - PubMed

MeSH terms

LinkOut - more resources