Increased C-reactive protein–triglyceride glucose index is associated with the incidence of hypertension in individuals without hypertension: a large-scale retrospective cohort study

Q: What are the key findings of this study?

Higher C-reactive protein-triglyceride-glucose index predicted incident hypertension in normotensive (OR 1.73; 95% CI 1.46-2.06) and elevated BP (OR 1.26; 95% CI 1.09-1.40) adults (both P<0.001).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: New-onset hypertension (n=6540). Intervention: C-reactive protein-triglyceride-glucose index (CTI). Primary outcome: New-onset hypertension (self-reported physician's diagnosis) (OR 1.73, 95% CI 1.46-2.06, p=<0.001).

Q: What does this research mean for the field?

An elevated C-reactive protein–triglyceride glucose index is an independent risk factor for incident hypertension and provides superior predictive ability compared to triglyceride or C-reactive protein levels alone. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Y Su; L M Wu

doi:10.1093/eurheartj/ehag785.3228

October 1, 2026European Heart JournalOpen Access

Increased C-reactive protein–triglyceride glucose index is associated with the incidence of hypertension in individuals without hypertension: a large-scale retrospective cohort study

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Key result

Higher C-reactive protein-triglyceride-glucose index linked to ~73% higher odds of incident hypertension.

OR 1.73
95% CI 1.46-2.06
P<0.001
n=6,540

Why the study?

The C-reactive protein-triglyceride-glucose index (CTI) reflects insulin resistance and inflammation, but its association with incident hypertension across normal and elevated blood pressure states remained unexplored.

Does the C-reactive protein-triglyceride-glucose index (CTI) predict the incidence of new-onset hypertension in individuals aged >45 years with normal or elevated blood pressure?

Key Points

To investigate the association between the C-reactive protein–triglyceride glucose index and the incidence of hypertension across normal and elevated baseline blood pressure categories.
Retrospective cohort study analyzing 6,540 participants aged >45 years from the China Health and Retirement Longitudinal Study (CHARLS), categorized at baseline into normotensive and elevated blood pressure groups.
The C-reactive protein–triglyceride glucose index (CTI) was calculated as 0.412 × Ln(CRP [mg/L]) + Ln(TG [mg/dL] × FPG [mg/dL])/2, with new-onset hypertension tracked over 9 years by self-reported physician diagnosis.
Logistic regression, restricted cubic splines, threshold analyses, and receiver operating characteristic analyses evaluated risk associations and predictive accuracy.
Over the 9-year follow-up, 1,868 of 6,540 participants (29.25%) developed new-onset hypertension.
CTI was an independent risk factor for hypertension, with an adjusted OR of 1.73 (95% CI, 1.46–2.06; p < 0.001) in normotensive individuals and 1.26 (95% CI, 1.09–1.40; p < 0.001) in those with elevated baseline blood pressure.
CTI exhibited superior predictive capability for new-onset hypertension compared to single measurements of triglycerides or C-reactive protein alone.

Study Design

Type

Cohort (n=6,540)

Structured PICO

Does the C-reactive protein-triglyceride-glucose index (CTI) predict the incidence of new-onset hypertension in individuals aged >45 years with normal or elevated blood pressure?

P

Population

6,540 Chinese adults aged >45 years without hypertension at baseline (normotensive or elevated blood pressure), followed for 9 years.

E

Exposure

C-reactive protein-triglyceride-glucose index (CTI), calculated as 0.412 Ln (CRP [mg/L]) + Ln (TG [mg/dL] × FPG [mg/dL])/2

C

Comparator

Single indicators of triglyceride (TG) and C-reactive protein (CRP)

O

Outcome

New-onset hypertension, defined as a self-reported physician’s diagnosis of hypertension over nine years of follow-uppatient reported

Main Result

Odds Ratio: 1.73 (95% CI 1.46–2.06)

p-value: p=<0.001

Limitations

Biases arising from self-reported hypertension diagnosis data
Biases arising from self-reported data for hypertension diagnosis
Retrospective cohort design

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

The C-reactive protein-triglyceride-glucose index (CTI) is an independent risk factor for new-onset hypertension in both normotensive and elevated blood pressure individuals, showing superior predictive ability compared to triglyceride or CRP alone.

Abstract

Background Hypertension is a major public health concern, emphasising the need for effective preventive strategies.The C-reactive protein-triglyceride-glucose index (CTI) represents a potential indicator of insulin resistance and an inflammatory response. However, the association between CTI and the incidence of hypertension remains unexplored. To address this knowledge gap, we conducted a large-scale retrospective cohort study to investigate the association between CTI and hypertension across different blood pressure (BP) states, including individuals with normal BP and those with elevated BP. Methods The China Health and Retirement Longitudinal Study (CHARLS) enrolled 6,540 participants aged >45 years. Based on the 2024 European Society of Cardiology (ESC) guidelines, participants were categorized into normotensive and elevated blood pressure groups at baseline. The primary outcome was new-onset hypertension, defined as a self-reported physician’s diagnosis of hypertension during the follow-up period.The CTI was obtained by 0.412 * Ln (CRP [mg/L]) + Ln (TG [mg/dL] × FPG [mg/dL])/2. Logistic regression models, restricted cubic splines models, and threshold analyses were employed to examine the relationship between CTI and the incidence of hypertension. Receiver Operating Characteristic analysis was utilized to assess the ability of CTI to predict the incidence of hypertension. Subgroup analyses were conducted across various demographic and health-related factors. Sensitivity analyses were employed to address biases arising from self-reported data. Results Among 6,540 participants,1,868(29.25%) developed hypertension over nine years. The CTI is an independent risk factor for the development of hypertension, with an adjusted odds ratio of 1.73[95% confidence interval (CI) 1.46–2.06, p < 0.001] in individuals with normal BP and 1.26 (95% CI 1.09–1.40, p < 0.001) in those with elevated BP. CTI demonstrates better predictive ability for the occurrence of hypertension compared to the single indicators of triglyceride (TG) and CRP.abstract picture

Discussion

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Cite This Study

Su et al. (2026) conducted a cohort in New-onset hypertension (n=6,540). C-reactive protein-triglyceride-glucose index (CTI) was evaluated on New-onset hypertension (self-reported physician's diagnosis) (OR 1.73, 95% CI 1.46-2.06, p=<0.001). Higher C-reactive protein-triglyceride-glucose index predicted incident hypertension in normotensive (OR 1.73; 95% CI 1.46-2.06) and elevated BP (OR 1.26; 95% CI 1.09-1.40) adults (both P<0.001).

synapsesocial.com/papers/6ae13d7f043bfbd635332b18 https://doi.org/10.1093/eurheartj/ehag785.3228

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Increased C-reactive protein–triglyceride glucose index is associated with the incidence of hypertension in individuals without hypertension: a large-scale retrospective cohort study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Increased C-reactive protein–triglyceride glucose index is associated with the incidence of hypertension in individuals without hypertension: a large-scale retrospective cohort study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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