American Journal of Preventive Cardiology (Sep 2025)
Triglyceride-glucose index threshold for cardiovascular mortality in hypertensive individuals - URRAH project
- Lanfranco D’Elia,
- Ferruccio Galletti,
- Masulli Maria,
- Agostino Virdis,
- Edoardo Casiglia,
- Valerie Tikhonoff,
- Fabio Angeli,
- Carlo Maria Barbagallo,
- Michele Bombelli,
- Federica Cappelli,
- Rosario Cianci,
- Michele Ciccarelli,
- Arrigo F G Cicero,
- Massimo Cirillo,
- Pietro Cirillo,
- Giovambattista Desideri,
- Claudio Ferri,
- Loreto Gesualdo,
- Cristina Giannattasio,
- Guido Grassi,
- Guido Iaccarino,
- Luciano Lippa,
- Francesca Mallamaci,
- Alessandro Maloberti,
- Stefano Masi,
- Alberto Mazza,
- Alessandro Mengozzi,
- Maria Lorenza Muiesan,
- Pietro Nazzaro,
- Paolo Palatini,
- Gianfranco Parati,
- Roberto Pontremoli,
- Fosca Quarti-Trevano,
- Marcello Rattazzi,
- Gianpaolo Reboldi,
- Giulia Rivasi,
- Elisa Russo,
- Massimo Salvetti,
- Giuliano Tocci,
- Andrea Ungar,
- Paolo Verdecchia,
- Francesca Viazzi,
- Massimo Volpe,
- Claudio Borghi
Affiliations
- Lanfranco D’Elia
- Department of Clinical Medicine and Surgery, ''Federico II'' University of Naples, 80131 Naples, Italy; Corresponding authors at: Department of Clinical Medicine and Surgery; ‘Federico II’ University of Naples, Via S. Pansini, 5 - 80131 Naples, Italy.
- Ferruccio Galletti
- Department of Clinical Medicine and Surgery, ''Federico II'' University of Naples, 80131 Naples, Italy; Corresponding authors at: Department of Clinical Medicine and Surgery; ‘Federico II’ University of Naples, Via S. Pansini, 5 - 80131 Naples, Italy.
- Masulli Maria
- Department of Clinical Medicine and Surgery, ''Federico II'' University of Naples, 80131 Naples, Italy
- Agostino Virdis
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Edoardo Casiglia
- Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy
- Valerie Tikhonoff
- Department of Medicine, University of Padua, 35100 Padua, Italy
- Fabio Angeli
- Department of Medicine and Technological Innovation (DiMIT), University of Insubria, Varese, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS Tradate (VA), Italy
- Carlo Maria Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90100 Palermo, Italy
- Michele Bombelli
- Internal Medicine, Pio XI Hospital of Desio, ASST Brianza, Department of Medicine and Surgery, University of Milano, Bicocca, Italy
- Federica Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Michele Ciccarelli
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
- Arrigo F G Cicero
- Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; Cardiovascular medicine unit, Heart-Chest-Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Massimo Cirillo
- Dipartimento Scuola Medica Salernitana, Università di Salerno, Baronissi SA, Italy
- Pietro Cirillo
- Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica (DiMePRe-J), ''Aldo Moro'' University of Bari, 70122 Bari, Italy
- Giovambattista Desideri
- Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- Loreto Gesualdo
- Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica (DiMePRe-J), ''Aldo Moro'' University of Bari, 70122 Bari, Italy
- Cristina Giannattasio
- Cardiology IV, ''A.De Gasperi's'' Department, Niguarda Ca' Granda Hospital, 20162 Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
- Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Guido Iaccarino
- Department of Clinical Medicine and Surgery, ''Federico II'' University of Naples, 80131 Naples, Italy
- Luciano Lippa
- Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy
- Francesca Mallamaci
- Department of Nephrology, Dialysis and Transplantation GOM ''Bianchi-Melacrino-Morelli'' & CNR-IFC, Institute of Clinical Physiology, Research Unit of Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension (European Society of Hypertension, ESH, Excellence Centre) of Reggio Calabria, Italy
- Alessandro Maloberti
- Cardiology IV, ''A.De Gasperi's'' Department, Niguarda Ca' Granda Hospital, 20162 Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy
- Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Alberto Mazza
- Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, Italy
- Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, 8952 Schlieren, Switzerland; Dipartimento Scuola Medica Salernitana, Università di Salerno, 84084 Baronissi-SA, Italy
- Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences and ''Centro studi diagnosi e cura dell'ipertensione arteriosa e del rischio cardiovascolare '', University of Brescia, 25121 Brescia, Italy
- Pietro Nazzaro
- Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, Italy
- Paolo Palatini
- Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy
- Gianfranco Parati
- S.Luca Hospital, IRCCS, Istituto Auxologico Italiano, 20149 Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- Roberto Pontremoli
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Fosca Quarti-Trevano
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Marcello Rattazzi
- Department of Medicine-DIMED, University of Padova, Medicina Interna 1°, Ca' Foncello University Hospital, 31100 Treviso, Italy
- Gianpaolo Reboldi
- Department of Medicine and Surgery, University of Perugia, 06100 Perugia, Italy
- Giulia Rivasi
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
- Elisa Russo
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Massimo Salvetti
- Department of Clinical and Experimental Sciences and ''Centro studi diagnosi e cura dell'ipertensione arteriosa e del rischio cardiovascolare '', University of Brescia, 25121 Brescia, Italy
- Giuliano Tocci
- Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, 00189 Rome, Italy
- Andrea Ungar
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
- Paolo Verdecchia
- Hospital S. Maria della Misericordia, 06100 Perugia, Italy
- Francesca Viazzi
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Massimo Volpe
- Dipartimento di Medicina Clinica e Molecolare, Università di Roma Sapienza, Roma, Italy; IRCCS San Raffaele Roma, Italy
- Claudio Borghi
- Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; Cardiovascular medicine unit, Heart-Chest-Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- DOI
- https://doi.org/10.1016/j.ajpc.2025.101053
- Journal volume & issue
-
Vol. 23
p. 101053
Abstract
Aims: The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance (IR). Data regarding this topic is constantly increasing, however, few and heterogeneous data are available on the relationship between this index and cardiovascular mortality risk in hypertensive populations. In this context, we aimed to explore the relationship between TyG and cardiovascular mortality in a large sample of hypertensive individuals from the URRAH cohort. Methods: A total of 12,275 hypertensive participants without previous cardiovascular events were included in this analysis. The risk of cardiovascular mortality was evaluated by the Cox regression analysis and competing risk regression analysis. Results: During a median follow-up of 10.5 years, 2151 deaths occurred, of which 986 were from cardiovascular disease. A linear association between TyG and cardiovascular mortality was found, in particular for a 1-standard deviation increase in TyG there was a significantly increased risk of 33 % (p < 0.0001). Furthermore, after stratification by the optimal cut-off point (4.54 Units), participants with TyG above the cut-off had a significantly increased risk of 67 % of cardiovascular mortality when compared with those with TyG below the cut-off (p < 0.0001). These results were also confirmed after adjustment for potential confounders. Conclusions: The results of this study indicate that this TyG threshold is predictive of an increased risk of cardiovascular mortality in a large sample of hypertensive individuals. This cut-off can identify individuals at higher mortality risk in already high-risk patients, with a low-cost and simple non-invasive marker.
Keywords
