Associations between novel triglyceride-glucose-related indices and the incidence of hypertension among Chinese middle-aged and elderly adults: a nationwide prospective cohort study

Background Novel triglyceride-glucose-related(TyG-related) indices have garnered increasing interest as predictors of cardiometabolic risk. However, their prospective associations with the indience of hypertension among middle-aged and elderly adults are insufficiently characterized. Methods We analysed 3150 participants aged 45 years or older, with no history of hypertension at baseline, from the China Health and Retirement Longitudinal Study (CHARLS). Cox proportional hazards regression and restricted cubic spline (RCS) regression analyses were applied to assess the associations between the novel TyG-related indices and incident hypertension. The robustness of the study findings was evaluated through subgroup and sensitivity analyses. Results In the longitudinal analysis, 1168 participants (37.1%) experienced an new-onset hypertension. In fully adjusted models, each 1-SD increase in TyG–BRI, TyG–ABSI, TyG–WWI, and TyG–CVAI was associated with hypertension hazards of 1.351 (95% CI, 1.149–1.588), 1.191 (1.093–1.298), 1.187 (1.088–1.295), and 1.325 (1.155–1.520), respectively. RCS analysis revealed a significant positive linear association between TyG-BRI and the risk of incident hypertension, whereas the other three indices demonstrated significant positive nonlinear associations with incident hypertension. ROC curve analysis indicated that TyG-ABSI and TyG-CVAI demonstrated relatively better predictive performance at 12-, 24-, and 60-month follow-ups. The findings were consistent across multiple subgroup and sensitivity analyses. Conclusion All four TyG-related indices were significantly associated with the risk of incident hypertension among middle-aged and older Chinese adults, emphasizing the need to increase attention to these indices to enhance hypertension detection and prevention in this population.