Exploring the relationship between triglyceride-glucose-body mass index and hypertension in relation to cardiovascular disease risk in an African population of type 2 diabetes patients

Background Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), with hypertension as a key contributor. The triglyceride–glucose–body mass index (TyG-BMI) has been proposed as a surrogate marker for insulin resistance and cardiometabolic risk. This study aimed to examine whether TyG-BMI is independently associated with hypertension and estimated 10-year CVD risk in Nigerian patients with T2DM. Methods This hospital-based cross-sectional study was conducted over a period of 13 months among patients with T2DM. Hypertension was defined by prior diagnosis or use of antihypertensive therapy, and 10-year CVD risk was estimated using the laboratory-based WHO risk chart validated for Western sub-Saharan Africa. Statistical analyses including correlation and multivariable logistic regression for evaluating associations between TyG-BMI, hypertension, and CVD risk were conducted using SPSS version 25, with significance set at p < 0.05. Results Among participants, 65.5% were hypertensive, and 44% had elevated 10-year CVD risk. TyG-BMI showed no independent association with hypertension (adjusted OR: 1.001, 95% CI: 0.995–1.007, p = 0.768) or elevated CVD risk (adjusted OR: 1.001, 95% CI: 0.994–1.008, p = 0.818). Rather, longer diabetes duration significantly increased the odds of hypertension (aOR per year: 1.170, 95% CI: 1.091–1.255, p < 0.001) and elevated CVD risk (aOR per year: 1.311, 95% CI: 1.211–1.420, p < 0.001). In extended models, hypertension (aOR: 3.923, 95% CI: 1.718–8.960, p = 0.001) and higher HbA1c (aOR: 1.276, 95% CI: 1.032–1.579, p = 0.025) were independently associated with elevated CVD risk, while TyG-BMI remained insignificant. Conclusion These findings suggest that traditional clinical indicators remain more informative than composite metabolic indices like TyG-BMI for cardiovascular risk stratification in sub-Saharan African patients with T2DM. Longitudinal multicentre studies incorporating direct measures of visceral adiposity and accounting for therapy effects are warranted to refine CVD risk prediction in this population.