Association between triglyceride glucose index trajectory and risk of hypertension in rural residents: a prospective cohort study

With changes in lifestyle, the incidence of hypertension in rural areas is on the rise. However, previous studies have not investigated the association between TyG index trajectories and the risk of hypertension in rural populations, particularly in multi-center natural population cohorts. Our study aimed to examine the association between TyG index trajectories and hypertension risk in rural populations. The study included 9343 rural residents from the Xinjiang Multi-Ethnic Cohort. The TyG index was calculated as Ln fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2, and a group-based trajectory model was adopted to identify the TyG index trajectories. Cox regression model was applied to assess the associations between the TyG index trajectories and incident hypertension. At a median follow-up period of 35 months, 1687 participants experienced hypertension. Three distinct TyG index trajectories were identified: low stable (n = 4239, 45.37%), moderate stable (n = 4561, 48.82%), and high stable (n = 543, 5.81%). Compared with the low stable group, the hazard ratio (95% CI) of hypertension was 1.41 (95% CI, 1.26-1.58) and 1.82 (95% CI, 1.50-2.21) for the moderate stable and high stable group, respectively. In subgroup analyses, the associations between a high TyG longitudinal trajectory and hypertension seemed to be stronger among participants with a high healthy lifestyle score (HLS) compared to those with a low HLS. In rural residents, elevated trajectories of the TyG index were associated with an increased risk of hypertension. This finding underscores the importance of paying attention to TyG levels, even among people with a healthy lifestyle.