TYG-WC as a clinical tool for stratification of hypertensive risk in non-diabetic adults: Large-scale NHANES analysis (2005-2016)

Background/Objectives:Hypertension risk stratification requires accessible metabolic tools. We evaluated three integrated indices that combine obesity and insulin resistance: TyG-BMI (triglyceride glucose-body mass index), TyG-WC (triglyceride glucose-waist circumference), and TyG-WHtR (triglyceride glucose-waist-to-height ratio). These indices were assessed for their ability to predict hypertension in non-diabetic adults. Methods:Using nationally weighted data from 9, 593 NHANES participants (2005-2016), we applied survey-adjusted multivariable logistic regression and restricted cubic splines (RCS) to assess associations. Subgroup analyses further identified targets for precision interventions. Results:  Tyg-WC showed a superior prediction of hypertension with a comprehensive regulation ratio (OR) of 4.09 (95% CI: 3.37–4.96). It exhibited a dose-response relationship close to linear (nonlinear = 0.082), outperforming tyg-bmi (OR = 3.45, 95% CI: 2.83–4.22) and tyg-whtr (OR = 3.91, 95% CI: 3.20-4.48). Glucose and its linear relationship with the risk of hypertension, TYG-WC is suitable for use as a continuous clinical variable. Furthermore, a TYG-WC cutoff of ≥600 provides the best risk stratification, effectively replacing more complex metabolic syndrome criteria. Abbreviation analysis showed that nonsmokers had enhanced TYG-WC sensitivity (interaction P = 0.012) and higher-educated individuals (P = 0.037). Conclusion:  TYG-WC is a practical, cost-effective tool for hypertension screening in primary care. Its linear association allows direct integration into the risk model. Values of ≥600 indicate that targeted intervention is required. Behavioral and socio-demographic factors further improve the precise prevention strategies.