Key result
High triglyceride-glucose index linked to ~41% higher first stroke risk in hypertensive patients.
Why the study?
The association of the triglyceride-glucose index, a surrogate biomarker for insulin resistance, with first stroke and potential influencing factors in a hypertensive population had not been evaluated.
Does a higher baseline triglyceride-glucose (TyG) index increase the risk of first stroke in a hypertensive population?
Cohort (n=7,569)
No
Does a higher baseline triglyceride-glucose (TyG) index increase the risk of first stroke in a hypertensive population?
Hazard Ratio: 1.41 (95% CI 1.1–1.81)
Absolute Event Rate: 4.4% vs 3.2%
p-value: p=0.007
An elevated baseline triglyceride-glucose index (≥8.8) is independently associated with a significantly higher risk of first stroke in hypertensive patients, particularly those aged 60 years or older.
Hypothesis-generating for TyG-based stroke risk stratification in hypertension; prospective trials needed before clinical adoption.
BACKGROUND: This study aimed to evaluate the association of triglyceride-glucose (TyG) index, an insulin resistance surrogate biomarker, with first stroke in a hypertensive population and to explore potential influencing factors. METHODS: This study, a cohort study among a rural Chinese hypertensive population, utilized data from the China Stroke Primary Prevention Trial (CSPPT). The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Multivariate analysis using Cox proportional hazards models was conducted. RESULTS: A total of 7569 hypertensive patients were included in this study. When TyG index was assessed as quartiles, compared with the reference group (Quartile 1), the hazard ratio of stroke was 1.04 in Quartile 2, 1.43 in Quartile 3, and 1.45 in Quartile 4, with a significant trend test (P = 0.013). When Quartiles 3 and 4 were combined (≥ 8.8), the hazard ratio was 1.41 compared with combined Quartiles 1 and 2 (< 8.8). Similar findings were observed for the association of TyG index with ischemic stroke. Further, a joint effect of baseline TyG index and age on first stroke was found. Using the group with TyG < 8.8 and age < 60 years as a reference, the highest hazard ratio of stroke was found in the group with a higher TyG index and aged 60 or greater (HR: 2.15, 95% CI 1.50, 3.07, P < 0.001). CONCLUSIONS: In a hypertensive population, baseline TyG index was associated with a significantly higher risk of first stroke. In addition, age was a significant effect modifier for this association.
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Zhang et al. (2023) conducted a cohort in Hypertension (n=7,569). High Triglyceride-glucose (TyG) index (≥ 8.8) vs. Low Triglyceride-glucose (TyG) index (< 8.8) was evaluated on First nonfatal or fatal stroke (HR 1.41, 95% CI 1.10-1.81, p=0.007). A baseline triglyceride-glucose index of 8.8 or higher was associated with a 41% increased risk of first stroke (HR 1.41) compared to lower levels in a hypertensive population.
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