Triglyceride-glucose index threshold for cardiovascular mortality in hypertensive individuals - URRAH project

Aims The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance (IR). Data regarding this topic is constantly increasing, however, few and heterogeneous data are available on the relationship between this index and cardiovascular mortality risk in hypertensive populations. In this context, we aimed to explore the relationship between TyG and cardiovascular mortality in a large sample of hypertensive individuals from the URRAH cohort. Methods A total of 12,275 hypertensive participants without previous cardiovascular events were included in this analysis. The risk of cardiovascular mortality was evaluated by the Cox regression analysis and competing risk regression analysis. Results During a median follow-up of 10.5 years, 2151 deaths occurred, of which 986 were from cardiovascular disease. A linear association between TyG and cardiovascular mortality was found, in particular for a 1-standard deviation increase in TyG there was a significantly increased risk of 33% (p<0.0001). Furthermore, after stratification by the optimal cut-off point (4.54 Units), participants with TyG above the cut-off had a significantly increased risk of 67% of cardiovascular mortality when compared with those with TyG below the cut-off (p<0.0001). These results were also confirmed after adjustment for potential confounders. Conclusions The results of this study indicate that this TyG threshold is predictive of an increased risk of cardiovascular mortality in a large sample of hypertensive individuals. This cut-off can identify individuals at higher mortality risk in already high-risk patients, with a low-cost and simple non-invasive marker.