Triglyceride-glucose index, HOmeostatic Model Assessment index, and new-onset hypertension in middle-aged men

Hypertension is a major risk factor for cardiovascular diseases. Insulin resistance is one of the main risk factor for hypertension. A simple index (triglyceride-glucose index - TyG) has been considered as a surrogate marker of insulin resistance. Although several studies have explored TyG and cardiovascular risk, few longitudinal data on the relationship between new-onset hypertension and this novel index are available so far, especially in European countries. Therefore, we aimed to estimate the predictive role of TyG, in comparison to that of the HOmeostatic Model Assessment of Insulin Resistance (HOMA-IR) index (a widely used tool to assess insulin resistance), on the development of hypertension, in an 8-year follow-up observation of a sample of adult men.

The analysis included 482 men (The Olivetti Heart Study), without hypertension at baseline. The optimal cut-off point of the association of continuous TyG or HOMA-IR index with new-onset hypertension was identified by receiver-operating characteristic (ROC) analysis.

TyG was linearly associated with the occurrence of new-onset hypertension, whereas HOMA-IR was nonlinearly related to the risk of developing hypertension. After stratification by the optimal cut-off point, TyG greater than 4.91 were significantly associated with new-onset hypertension, also after adjustment for main confounders. In contrast, the HOMA-IR index greater than 1.82 was not associated with the risk of new-onset hypertension in the adjusted models.

The principal findings of this study suggest that the TyG index exhibits a significant predictive capacity for the development of new-onset hypertension. Although its limited sensitivity, the results support the potential utility of TyG as a simple, cost-effective, and noninvasive adjunctive tool for the early assessment of cardiovascular risk.