Study on the relationship between C-reactive protein-triglyceride-glucose index and risk of hypertension in middle-aged and elderly individuals

Liu Yixuan; Wang Kexin; Wang Wenjie; Niu Jialong; Wang Zhongke; Liu Xiaoli; Wang Zhijian; Han Hongya; Ge Hailong

doi:10.3760/j.issn.1673-4777.2026.04.001

Abstract：Objective To investigate the association between C-reactive protein-triglyceride-glucose index(CTI)and hypertension based on data from the China health and retirement longitudinal study(CHARLS).Methods Participants aged ≥ 45 years recorded in the CHARLS database from 2011 to 2015 were enrolled.Cox regression was used to analyze the relationships of continuous CTI and CTI subgroups with the risk of incident hypertension.Restricted cubic spline(RCS)analysis was performed to explore the dose-response relationship between CTI and hypertension risk.Subgroup analyses were conducted according to age(≥ 60 years or not),gender,residence,smoking,and drinking status.Results A total of 5 210 participants were included,among whom 1 579 developed incident hypertension(hypertension group)and the remaining 3 631 were included in the non-hypertension group.Compared with the non-hypertension group,participants in the hypertension group were older,had a higher proportion of males,a lower proportion of married individuals,higher percentages of smokers and drinkers,higher prevalence rates of heart disease,diabetes,stroke,dyslipidemia,and lung disease,as well as higher levels of low-density lipoprotein cholesterol,body mass index,and CTI(all P＜0.05).Participants were divided into three groups by tertiles of CTI:T1(5.99≤CTI≤8.27),T2(8.27＜CTI ≤8.96),andT3(8.96＜CTI ≤ 12.79).In model 3,CTI was significantly associated with an increased risk of incident hypertension(hazard ratio=1.16,95％confidence interval:1.08-1.25,P＜0.001).Compared with T1,both T2 and T3 were signifi-cantly related to an increased risk of incident hypertension(T2:hazard ratio=1.20,95％confidence interval:1.04-1.38,P=0.015;T3:hazard ratio=1.35,95％confidence interval:1.17-1.57,P＜0.001).Trend test indicated that the risk of incident hypertension was significantly associated with elevated CTI subgroups(Pfor trend＜0.001).RCS analysis showed a linear relationship between CTI and the risk of hypertension in middle-aged and elderly Chinese individuals(Poverall＜0.001,Pnonlinear=0.254).Subgroup analyses revealed that the positive association between CTI and hypertension risk was significant in males and rural residents,and was not affected by age,smoking,or drinking status.Conclusion CTI increase is a risk factor for hypertension in middle-aged and elderly individuals.