TYG-WC as a clinical tool for stratification of hypertensive risk in non-diabetic adults: Large-scale NHANES analysis (2005-2016)

Background/ObjectivesHypertension risk stratification requires accessible metabolic tools. We evaluated three integrated indices that combine obesity and insulin resistance: TyG-BMI (triglyceride glucose-body mass index), TyG-WC (triglyceride glucose-waist circumference), and TyG-WHtR (triglyceride glucose-waist-to-height ratio). These indices were assessed for their ability to predict hypertension in non-diabetic adults. MethodsUsing nationally weighted data from 9, 593 NHANES participants (2005-2016), we applied survey-adjusted multivariable logistic regression and restricted cubic splines (RCS) to assess associations. Subgroup analyses further identified targets for precision interventions. ResultsTyG-WC showed superior prediction for hypertension, with a fully adjusted odds ratio (OR) of 4.09 (95% CI: 3.37-4.96). It exhibited a near-linear dose-response relationship (P for nonlinearity = 0.082), outperforming TyG-BMI (OR = 3.45, 95% CI: 2.83-4.22) and TyG-WHtR (OR=3.91, 95% CI: 3.20-4.78).Because of its simplicity--requiring only waist circumference, triglycerides, and glucose--and its linear relationship with hypertension risk, TyG-WC is suitable for use as a continuous clinical variable. Moreover, a TyG-WC cutoff of [≥]600 offers optimal risk stratification, effectively replacing more complex metabolic syndrome criteria.Subgroup analyses revealed enhanced TyG-WC sensitivity in non-smokers (interaction P=0.012) and higher-educated individuals (P=0.037). ConclusionsTyG-WC is a practical, cost-effective tool for hypertension screening in primary care. Its linear association allows direct integration into risk models. A value of [≥]600 indicates the need for targeted intervention. Behavioral and sociodemographic factors further refine precision prevention strategies.