Metabolic biomarkers and cardiovascular risk stratification in hypertension

Introduction

Cardiovascular risk calculators (CRC) are not locally validated and calibrated. Surrogate biomarkers of insulin resistance had identified subjects at higher risk of type 2 diabetes and cardiovascular disease.

Aim

Establish the frequency of surrogate biomarkers of insulin resistance and their correlation with CRC in primary prevention non-diabetic hypertensive subjects.

Methods

This is an observational registry with a prospective consecutive outpatient's sample. The TyG index (TyGi) was calculated as logarithm (Ln) of (fasting triglycerides [mg/dl] × fasting plasma glucose [mg/dl]/2). Patients were stratified according to quartiles of TyGi. Pearson correlation coefficient between TyGi and other relevant variables was evaluated.

Results

Four hundred six patients were included with a mean age 55.9 ± 13 years, 231 p (56.9%) males. The mean TyGi was 8.667 ± 0.53. Patients in the highest quartiles of TyGi had significantly higher median difference between expected and actual ASCVD risk (p = 0.02), higher frequency of AHA/ACC Pooled Cohort Equation >7.5% (p < 0.005), and higher levels of metabolic biomarkers such as median triglyceridemia/HDL cholesterol ratio (TG/HDL) (p < 0.0005), glycaemia and A1C (p < 0.001 and p = 0.02, respectively). The correlation between TyGi and TG/HDL was highly significant (r = 0.7076; r² = 0.5007; p < 0.0001), and intermediate with non-HDL cholesterol (r = 0.4553, r² = 0.2073; p < 0.0001).

Conclusions

Non-diabetic hypertensive patients with high TyGi, a surrogate biomarker of insulin resistance, had a higher 10-year cardiovascular risk by AHA/ACC Pooled Cohort Equation. TyGi is statistically and significantly correlated with other biomarkers of insulin resistance. TyGi could be a reliable biomarker in clinical practice to stratify cardiovascular risk.