Association fasting blood sugar to high-density lipoprotein cholesterol ratio and hypertension: Analysis from the National Health and Nutrition Examination Survey (2003– 2018)

Hypertension is a chronic disease that poses a significant threat to human health worldwide. The ratio of fasting blood sugar to high-density lipoprotein cholesterol (GHR) is an emerging biomarker associated with various diseases. However, the relationship between GHR and hypertension was still unclear. This study aimed to explore the correlation between GHR and high blood pressure. The study conducted a comprehensive cross-sectional analysis based on data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. The study used a multivariate logistic regression model to evaluate the relationship between GHR and hypertension. It also verified the robustness of the results through subgroup analysis. In addition, the study used restricted cubic splines (RCS) to analyze the possible nonlinear relationship between GHR and hypertension, as well as to explore potential threshold effects. Finally, the study evaluated the predictive efficiency of GHR for hypertension through receiver operating characteristic (ROC) curve analysis. The results showed that, without adjusting for confounding factors, GHR was positively correlated with hypertension (OR = 1.20, 95%CI = 1.17–1.22, P < 0.001). After fully adjusting for confounding factors (including gender, race, age, body mass index, smoking status, alcohol consumption, diabetes, stroke, total cholesterol, and creatinine), the positive correlation between GHR and hypertension still existed (OR = 1.06, 95%CI = 1.03–1.09, P < 0.001). Subgroup analysis further showed that the association between GHR and hypertension remained consistent across different subgroups. In addition, ROC analysis revealed a nonlinear relationship between GHR and hypertension, with a turning point of 2.36. Furthermore, ROC analysis indicated that GHR demonstrated high predictive efficiency in univariate and multivariate-adjusted models. A positive correlation was demonstrated between GHR and hypertension. GHR had the potential to serve as a biological marker for hypertension, facilitating its prevention and diagnosis.