Cholesterol, high-density lipoprotein, and glucose index and stroke risk in patients with hypertension in China: a prospective cohort study

Objective : The relationship between the Cholesterol, High-density lipoprotein, and Glucose (CHG) index and stroke has been investigated in only a limited number of studies, and the findings remain inconsistent. This prospective cohort study aims to provide further evidence on the association between the CHG index and stroke risk in patients with hypertension. Methods : A total of 9591 subjects were enrolled in this prospective cohort analysis. The CHG index was calculated, and incident stroke was identified as the outcome. Cox proportional hazards models were employed to examine the association between the CHG index and stroke risk. Restricted cubic splines (RCS) were used to evaluate the dose-response relationship. Results : Over a mean follow-up of 3.96 years, 383 (4.0%) patients developed new-onset stroke. After multivariate adjustment, each 1-unit increase of CHG index was associated with a 204% higher risk of stroke (HR=3.04, 95%CI: 1.79, 5.17). Compared with participants in the lowest quartile (Q1) of the CHG index, those in Q2, Q3, and Q4 had fully adjusted HRs (95% CI) for stroke of 1.66 (1.22–2.25), 1.86 (1.33–2.60), and 2.59 (1.76–3.79), respectively. RCS analysis revealed a positive linear association between the CHG index and stroke risk, and this association remained consistent across subgroups, with no significant interactions. Conclusions : An elevated CHG index is significantly and linearly associated with increased stroke risk in hypertensive patients. The CHG index may serve as a useful early indicator for stroke risk assessment in this population.