What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=8732). Intervention: Stress hyperglycemia ratio (SHR) vs. Reference quartile (Q2). Primary outcome: Albuminuria (OR 2.34, 95% CI 1.62-3.36, p=<0.001).

What does this research mean for the field?

An elevated stress hyperglycemia ratio is significantly and independently associated with increased odds of albuminuria in adults with hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study examines the relationship between stress hyperglycemia ratio and albuminuria in hypertensive individuals.

May 16, 2026Open Access

The Association Between Stress‐Induced Hyperglycemia Ratio and Increased Urinary Albumin Excretion in Patients With Hypertension: A Population‐Based Study

Q: What are the key findings of this study?

An elevated stress hyperglycemia ratio was significantly associated with increased odds of albuminuria in US adults with hypertension (OR 2.34; 95% CI 1.62-3.36; p < 0.001).

Q: What does this research mean for the field?

An elevated stress hyperglycemia ratio is significantly and independently associated with increased odds of albuminuria in adults with hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

This study examines the relationship between stress hyperglycemia ratio and albuminuria in hypertensive individuals.

Key Result

An elevated stress hyperglycemia ratio was significantly associated with increased odds of albuminuria in US adults with hypertension (OR 2.34; 95% CI 1.62-3.36; p < 0.001).

Key Points

This study examines the relationship between stress hyperglycemia ratio and albuminuria in hypertensive individuals.
Cross-sectional analysis of 8732 hypertensive adults from the National Health and Nutrition Examination Survey 2005–2018.
Multivariable logistic regression evaluated the association between SHR and albuminuria, adjusting for demographic and clinical factors.
Restricted cubic splines were used to assess nonlinear relationships.
15% prevalence of albuminuria was observed in the cohort.
The highest quartile of SHR was associated with increased odds of albuminuria (OR: 2.34; 95% CI: 1.62–3.36; p < 0.001).
RCS analysis indicated a J-shaped relationship between continuous SHR and albuminuria, with risk increasing notably beyond an SHR of 0.91.

Study Design

Type

Cross-Sectional (n=8,732)

Multicenter

Yes

Structured PICO

Is an elevated stress hyperglycemia ratio associated with an increased prevalence of albuminuria in adults with hypertension?

Population

8,732 adults with hypertension from the US National Health and Nutrition Examination Survey (NHANES) 2005–2018

Intervention

Elevated stress hyperglycemia ratio (SHR) (highest quartile)

Comparator

Reference quartile (Q2) of stress hyperglycemia ratio (SHR)

Outcome

Prevalence of albuminuriasurrogate

An elevated stress hyperglycemia ratio is independently associated with a higher prevalence of albuminuria in US adults with hypertension, highlighting its potential utility as a marker for early renal damage.

Main Result

Effect estimate: OR 2.34 (95% CI 1.62-3.36)

p-value: p=<0.001

Abstract

ABSTRACT The stress hyperglycemia ratio (SHR), a novel marker reflecting relative hyperglycemia, has been increasingly recognized for its prognostic value in cardiovascular and metabolic diseases. However, its association with early renal damage in hypertensive patients remains underexplored. This study aims to investigate the independent relationship between SHR and albuminuria in a nationally representative cohort of adults with hypertension. This cross‐sectional analysis included 8732 adults with hypertension from the National Health and Nutrition Examination Survey 2005–2018. Multivariable logistic regression models were used to evaluate the independent association between SHR and albuminuria, with adjustment for demographic, lifestyle, and clinical covariates. Restricted cubic splines (RCS) were employed to model nonlinear relationships. Stratified analyses were conducted across various subgroups. The prevalence of albuminuria was 15%. After full adjustment for confounders, compared to the reference quartile (Q2), the highest SHR quartile was significantly associated with an increased odds of albuminuria (OR: 2.34; 95% CI: 1.62–3.36; p 0.05). In this large, population‐based study, an elevated SHR is significantly and independently associated with a higher prevalence of albuminuria among US adults with hypertension.