Association between the triglyceride-glucose index and carotid-femoral pulse wave velocity in rural hypertensive adults

Background Triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and has been linked with cardiovascular outcomes. However, its association with arterial stiffness is understudied, particularly among hypertensive adults. Objectives To explore the association between TyG index and arterial stiffness, assessed by carotid-femoral pulse wave velocity (cfPWV), among a group of rural dwelling hypertensive adults. Methods A total of 12,751 hypertensive participants from the Hypertension and Stroke Prevention and Control Project (HSPCP) were analyzed. cfPWV was measured noninvasively using a PulsePen device (WPP001-ET, DiaTecne s.r.l.). TyG index was calculated as ln [fasting triglycerides (mg/dL) ×fasting glucose (mg/dL)/2]. Multivariate linear regression and log-binomial regression were used to explore the cross-sectional association between TyG index and cfPWV. Subgroup analyses were applied to identify potential effect modifiers. Results The mean age was 59.8 years, with 37.3% being male. The mean TyG index was 8.9 (SD, 0.7), and the mean cfPWV was 9.3 m/s. In the multivariable-adjusted model, a higher TyG index was associated higher cfPWV (β = 0.15 [95% CI: 0.10–0.21]). When analyzed as quartiles, participants in the highest quartile of the TyG index (≥ 9.2) had the highest level of cfPWV (β = 0.28 [95% CI 0.17–0.38]; ref=lowest quartile), and was dose-dependent. Additionally, each unit increase in the TyG index was associated with a 12% increased risk of elevated cfPWV. Participants in the highest TyG index quartile had a 26% greater likelihood of having cfPWV > 10 m/s compared to those in the lowest quartile. In sensitivity analysis, adjusting for fasting glucose reduced but did not eliminate the association (β = 0.07 [95% CI: 0.03–0.11]). Each unit increase in the TyG index was linked to a 7% higher prevalence of elevated cfPWV after adjusting for fasting glucose (RR = 1.07 [95% CI: 1.04–1.11]). Subgroup analysis indicated a stronger association in non-obese participants, though this should be interpreted with caution. Conclusion The TyG index was positively associated with measured cfPWV among rural hypertensive adults in cross-sectional analyses. These findings suggest that the TyG index may be related to subclinical central arterial stiffness in this population.