The prognostic value of the triglyceride-glucose index in individuals with hypertension

Hypertension frequently coexists with metabolic abnormalities that contribute to cardiovascular risk. The triglyceride-glucose (TyG) index is a simple surrogate marker of insulin resistance that may also reflect early cardiometabolic and cardiovascular vulnerability. This narrative review examines the prognostic relevance of TyG for all-cause mortality, cardiovascular mortality, and fatal or non-fatal cardiovascular events in hypertension. PubMed, Embase, and the Cochrane Library were searched through 5 October 2026, without date or language restrictions. Evidence from primary hypertensive cohorts generally supports associations between higher TyG and adverse outcomes, although their magnitude and shape vary, with both linear and nonlinear patterns reported. Findings are most consistent among hypertensive patients with diabetes, whereas results from other high-risk settings and hypertension-specific subgroup analyses are more heterogeneous. Differences in TyG calculation, modeling, glycemic status, clinical settings, and overlapping cohorts complicate comparisons across studies. Overall, TyG may represent a readily available, low-cost marker of early cardiometabolic and cardiovascular vulnerability, beyond its role as a surrogate of insulin resistance, with potential to refine cardiovascular risk stratification in hypertension. Further prospective validation should establish its incremental predictive value beyond conventional cardiovascular risk factors and established risk scores.