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