ArticleJournal of clinical hypertension (Greenwich, Conn.)2025
The Prognostic Value of Insulin Resistance Indices for Major Adverse Cardiovascular Events in Young and Middle-Aged Patients With Hypertension.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Association of Triglyceride-Glucose Index, Triglyceride/HDL Cholesterol Ratio and Metabolic Score for Insulin Resistance With Asymptomatic Organ Damage in Previously Untreated Patients With Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Insulin Resistance Indices and Cardiovascular Risk Prediction in Young Hypertensive Populations: Interpretative Challenges.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- The insulin resistance-systemic vascular resistance-isolated diastolic hypertension axis: a metabolic framework for an overlooked hypertension phenotype.Frontiers in cardiovascular medicine · 2026Review
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Authors and funding
10 authors.
Funding
Abstract
Young and middle-aged adults with hypertension develop the disease earlier and accrue longer exposure to elevated blood pressure, conferring higher lifetime cardiovascular risk. However, reliable markers predicting long-term major adverse cardiovascular events (MACEs) in this group remain unclear. Insulin resistance (IR) is crucial to hypertensive pathophysiology, but direct measurement is impractical. We evaluated the prognostic value of three laboratory-derived IR indices, the triglyceride-glucose (TyG) index, the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C), and the metabolic score for IR (METS-IR), in predicting MACEs. In this retrospective cohort of 4861 patients aged 18-65 years with primary hypertension, baseline indices were calculated and classified into tertiles. Patients were followed for a median of 73 months, during which 372 MACEs occurred. Multivariable Cox regression showed that higher TyG, TG/HDL-C, and METS-IR were independently associated with increased MACEs risk. In fully adjusted models, each standard deviation increase in METS-IR conferred a 55.7% higher risk (HR = 1.557, 95% CI: 1.154-2.101, p < 0.01), and patients in the highest tertile had more than double the risk vs. the lowest. METS-IR showed superior discrimination (AUC = 0.803, 95% CI: 0.774-0.886) and significant net reclassification improvement (NRI = 0.147, 95% CI: 0.073-0.239, p = 0.001) and integrated discrimination improvement (IDI = 0.006, 95% CI: 0.002-0.010, p = 0.002), whereas TyG showed borderline benefit and TG/HDL-C offered no incremental value. These findings highlight METS-IR as a pragmatic predictor of long-term cardiovascular risk in younger hypertensive patients, supporting its integration into clinical risk stratification.
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