Changes in the triglyceride-glucose-body mass index estimate the risk of hypertension among the middle-aged and older population: a prospective nationwide cohort study in China in the framework of predictive, preventive, and personalized medicine.

Background: Hypertension is a major modifiable cause of cardiovascular diseases and premature death worldwide. The triglyceride-glucose-body mass index (TyG-BMI), as a novel indicator, has been proposed for assessing hypertension risk. Nevertheless, a paucity of studies has explored the predictive potential of dynamic TyG-BMI for hypertension. The purpose of this study was to investigate whether cumulative TyG-BMI could better predict hypertension incidence and explore the interplay between TyG and BMI in hypertension development. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that dynamic monitoring of TyG-BMI level and joint assessment of TyG and BMI provide novel insights for individual risk assessment, targeted prevention, and personalized intervention of cardiovascular diseases. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide cohort conducted between 2011 and 2018, the changes in TyG-BMI between 2012 and 2015 were categorized into four groups by Results: A total of 2891 participants were enrolled, among whom 386 (13.4%) developed hypertension during a median 36.5-month follow-up period. Logistic regression analysis revealed that, compared to participants with persistently low TyG‑BMI, an increased risk of hypertension was observed among those with a moderate (odds ratio (OR) = 1.60, 95% confidence interval (CI) 1.15 to 2.22), a higher (OR = 1.93, 95% CI 1.28 to 2.89), and the highest TyG‑BMI (OR = 2.33, 95% CI 1.35 to 4.03). A positive linear association of cumulative TyG-BMI with hypertension was discovered ( Conclusions: This study demonstrated a significant positive association between dynamic TyG-BMI and hypertension among the Chinese middle-aged and older population. In the context of PPPM/3PM, long-term monitoring of TyG-BMI could assist in identifying individuals at high risk of hypertension, strengthening primary prevention efforts and facilitating prompt intervention strategies. In addition, this study revealed the mutual effect of TyG and BMI on hypertension development, which provides a novel approach for mitigating the risk of cardiovascular diseases via addressing metabolic disorders, thereby enhancing effective prevention and targeted intervention. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00380-6.