ArticleBMC primary care2026
Triglyceride-glucose index normalized by waist circumference and life's simple 7 to identify high-risk hypertensive patients in primary care.
Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHypertension affects over one billion adults and remains the leading contributor to global cardiovascular mortality. The triglyceride-glucose index normalized by waist circumference (TyG-WC) is emerging as a surrogate measure of insulin resistance and visceral adiposity, both associated with metabolic disorders and higher cardiovascular risk. Ideal cardiovascular health metrics (CVHM) from the American Heart Association's Life's Simple 7 (LS7) are strongly associated with reduced cardiovascular risk. Previous analyses from this cohort also demonstrated significant associations between LS7-derived CVHM and adverse clinical outcomes. However, it remains unclear whether TyG-WC provides additional and complementary prognostic information beyond LS7 in hypertensive patients. Therefore, the prognostic value of assessing the TyG-WC index together with the LS7 score to identify high-risk hypertensive patients in primary care remains largely unexplored.
methodsWe conducted a longitudinal cohort study of 243 hypertensive adults from a primary-care center in Tenerife, Spain. Baseline TyG-WC index, LS7 metrics, anthropometric variables, biochemical parameters, and comorbidities were recorded. Outcomes included hypertension-mediated organ damage (HMOD) and related comorbidities (HRC), all-cause hospitalization, and mortality. Participants were followed for a minimum of two years, with HMOD-HRC, all-cause hospitalization, and all-cause mortality data updated through September 2025. Logistic regression analyses evaluated the independent associations of TyG-WC and CVHM with the adverse composite outcome (HMOD-HRC, hospitalization, and death).
resultsHigher TyG-WC quartiles were associated with the composite outcome: OR 2.23 (Q2), 2.96 (Q3), and 5.12 (Q4) versus Q1. Associations between CVHM scores and clinical outcomes were consistent with previous findings from this cohort. Only 10.7% of participants achieved 4-5 ideal LS7 metrics, whereas 41.2% had 0-1. Higher CVHM scores were also associated with lower body mass index, waist-to-height ratio, fasting glucose, triglycerides, hs-CRP, and with a lower prevalence of diabetes and cardiovascular disease. TyG-WC increased progressively across poorer CVHM categories.
conclusionsElevated TyG-WC independently predicted HMOD-HRC, hospitalization, and all-cause mortality. The associations observed for LS7-derived cardiovascular health metrics were consistent with previous reports from this cohort. Assessing both TyG-WC and LS7 may strengthen cardiometabolic risk stratification in hypertensive primary-care populations.
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