Relationship Between the Triglyceride Glucose Index and the Risk of First Stroke in Elderly Hypertensive Patients

Longlong Hu,1 Huihui Bao,1,2 Xiao Huang,1 Wei Zhou,1,2 Tao Wang,1,2 Lingjuan Zhu,1,2 Xi Liu,3 Minghui Li,1,3 Xiaoshu Cheng1,2 1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 3Center of Cardiovascular Medicine, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia, People’s Republic of ChinaCorrespondence: Minghui LiCenter of Cardiovascular Medicine, Inner Mongolia People’s Hospital, No. 20 Zhaowuda Road, Hohhot, Inner Mongolia, 010017, People’s Republic of China, Tel +8615389819973, Fax +86-791-86262262, Email 15389819973@163.comXiaoshu ChengDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +8613607089128, Fax +86-791-86262262, Email xiaoshumenfan126@163.comBackground: Several recent studies have shown the relationship between the triglyceride glucose (TyG) index and the risk of stroke in the general population and in a few patient cohorts; however, the role of the TyG index on stroke risk in elderly hypertensive patients has not been determined. Thus, we aimed to investigate the association of the TyG index with first stroke and first ischemic stroke in elderly individuals with hypertension.Methods: We included 8487 elderly subjects with hypertension from the China H-type Hypertension Registry Study for the current analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Outcomes were the first stroke and first ischemic stroke.Results: During a median follow-up of 1.72 years, the first stroke was diagnosed in 82 patients (0.97%), and the first ischemic stroke was diagnosed in 48 patients (0.57%). Multivariable Cox proportional hazards models revealed that the TyG index was positively associated with the risk of first stroke (per 1-unit increment; HR: 1.72; 95% CI: 1.07, 2.76) and first ischemic stroke (HR: 2.31; 95% CI: 1.32, 4.05). When the TyG index was assessed as quartiles, significantly higher risks of first stroke (HR: 1.90; 95% CI: 1.04, 3.45) and first ischemic stroke (HR: 2.45; 95% CI: 1.16, 5.20) were found in participants in quartile 4 compared with those in quartiles 1– 3.Conclusion: The TyG index is potentially useful in the early identification of elderly hypertensive patients at high risk of experiencing a first stroke.Keywords: triglyceride glucose index, stroke, ischemic stroke, hypertension