Association between triglyceride-glucose body mass index and the risk of adverse cardiovascular events in middle-aged and elderly hypertensive patients

Ren Lu; Jiang Xianyun; Yang Jingyi

doi:10.3760/j.issn.1673-4777.2026.07.010

Abstract：Objective To explore the association between triglyceride-glucose body mass index(TyG-BMI)and the risk of adverse cardiovascular events in middle-aged and elderly hypertensive patients.Methods A total of 2 981 middle-aged and elderly hypertensive patients aged ≥45 years from the 2011 wave of the China health and retirement longitudinal study database were enrolled.During follow-up until 2015,233 patients developed new-onset adverse cardiovascular events(cardiovascular event group),and 2 748 patients remained free of adverse cardiovascular events(non-cardiovascular event group).Cox proportional hazards models were used to analyze the relationship of continuous TyG-BMI and categorized TyG-BMI[stratified by the median TyG-BMI of the study population(212.1)as the cut-off value;participants were divided into low-value group(102.4-212.1)and high-value group(＞212.1-432.1)]with the risk of adverse cardiovascular events.Restricted cubic splines were plotted to analyze the dose-response relationship between TyG-BMI and the risk of adverse cardiovascular events in middle-aged and elderly hypertensive patients.Subgroup analyses were performed stratified by age(＜60 years vs ≥ 60 years),gender,diabetes history,smoking history and drinking history.Results The levels of body mass index,low-density lipoprotein cholesterol,serum uric acid,C-reactive protein,glycated hemoglobin and TyG-BMI in the cardiovascular event group were higher than those in the non-cardiovascular event group(all P＜0.05).In addition,the preva-lence rates of hyperlipidemia,diabetes mellitus and renal diseases were significantly higher,while high-density lipo-protein cholesterol and systolic blood pressure levels were lower in the cardiovascular event group compared with the non-cardiovascular event group(all P＜0.05).When TyG-BMI was included as a continuous variable in Cox proportional hazards regression analysis for the overall population,it was positively associated with the risk of adverse cardiovascular events across all models.In the fully adjusted Model 3 stratified by the median TyG-BMI,the high-value group had a 36％increased risk of adverse cardiovascular events relative to the low-value group(hazard ratio=1.36,95％confidence interval:1.05-1.76,P=0.020).The risk estimates of TyG-BMI(the second quartile versus the first quartile)were consistent with those of the overall population across all subgroups(i.e.,higher TyG-BMI corresponded to elevated risk),with no significant heterogeneity observed within each subgroup(the P values for interaction tests stratified by age,diabetes history,drinking status,gender and smoking history were 0.157,0.518,0.679,0.803 and 0.807,respectively).The elevated risk of adverse cardiovascular events indicated by increased TyG-BMI remained relatively stable across subgroups.Conclusions Elevated TyG-BMI is a risk factor for adverse cardiovascular events in middle-aged and elderly hypertensive patients.This indicator is easy to calculate and cost-effective,and can serve as a potential simple tool for evaluating cardiac risk in hypertensive patients.