Insights into the complex relationship between triglyceride glucose-waist height ratio index, mean arterial pressure, and cardiovascular disease: a nationwide prospective cohort study

作者：Jie Xu, Dihui Cai, Yuheng Jiao, Yingying Liao, Yinyin Shen, Yunli Shen, Yunli Shen, Yunli Shen, Wei Han · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02657-0 · 被引用次数：19 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Health and Disease Prevention、Blood Pressure and Hypertension Studies

BACKGROUND: Both the triglyceride glucose-waist height ratio (TyG-WHtR) index and elevated arterial blood pressure are risk factors for cardiovascular disease (CVD). However, it is uncertain whether the TyG-WHtR index can increase the risk of CVD by influencing arterial blood pressure, and the extent to which the TyG-WHtR index may mediate the association between arterial blood pressure and CVD. The purpose of this study is to evaluate complex association of the TyG-WHtR index and mean arterial pressure (MAP) with CVD. METHODS: All data in this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) free of CVD at baseline. CVD was defined as self-reporting heart disease and stroke. Cox proportional hazards model and restricted cubic spline (RCS) were used to analyze the association of the TyG-WHtR index and MAP with the risk of CVD. Time-dependent receiver operating characteristic (ROC) analysis was used to assess the predictive performance of TyG-WHtR, MAP for CVD. Four-way decomposition method explored the mediating effects of the TyG-WHtR index and MAP in CVD. RESULTS: A total of 7976 participants were included in this study. The mean age of the participants was 58.68 ± 9.60 years, and 4263 (53.45%) were females. During a maximum follow-up of 7.0 years, 1326 (16.62%) people developed CVD. Both the TyG-WHtR index and MAP were signifcantly associated with CVD. The RCS regression analyses demonstrated a positive linear association of the TyG-WHtR...