Association of the Metabolic Score for Insulin Resistance With Incident Heart Failure in Patients With Hypertension

Objective: The association of the metabolic score for insulin resistance (METS-IR) with heart failure (HF) risk in hypertensive patients remains uncertain. This study aimed to examine the relationship of the METS-IR with incident HF in hypertensive patients. Design and method: A total of 12,066 patients, free of prior HF, were enrolled. Using multivariable Cox regression models, hazard ratios (HRs) and 95% confidence intervals (CIs) for HF were calculated. Results: 464 incident HF events were identified over a median follow-up of 5.00 years. Increases in METS-IR per SD were linked to a higher risk of HF (adjusted HR: 1.17; 95% CI: 1.07, 1.28). When METS-IR was evaluated as quartiles, compared with those in the first quartile, the adjusted HRs (95% CI) of incident HF in participants in the second, third, and fourth quartiles were 1.02 (0.77, 1.35), 1.26 (0.97, 1.64), and 1.43 (1.10, 1.85), respectively. Each 1 SD increase in METS-IR was significantly associated with a 17% increase in HF incidence after multivariate adjustment using Model 3. However, restricted cubic spline analysis showed no dose-response connection between METS-IR and HF risk (P for non-linearity = 0.113). Conclusions: In summary, the current investigation has discovered that elevated METS-IR is associated with an increased risk of HF in hypertensive patients. If more research supports our findings, METS-IR might be a helpful and practical indicator for the early identification of hypertensive patients at high risk of HF.