Insulin Resistance Bio-Anthropometric Markers Predict Hypertension Control in Individuals Without Diabetes

Aims Insulin resistance (IR), often associated with visceral adiposity, contributes to the development of dyslipidaemia and hypertension through various mechanisms. IR bio-anthropometric indices, such as triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), triglyceride-glucose index (TyGi), TyGi-body mass index (TyGi-BMI), TyGi-waist circumference (TyGi-WC), lipid accumulation product (LAP), visceral adiposity index (VAI), and metabolic score for insulin resistance (METS-IR), correlate with hypertension risk and poor blood pressure control when assessed via office blood pressure (OBP). However, their associations with 24 h ambulatory BP (ABP) and antihypertensive therapy remain unclear. This study examines the relationships between IR indices and ABP in outpatients without diabetes.Methods and results This cross-sectional study included 1336 outpatients undergoing ABP monitoring. IR indices were calculated, and antihypertensive therapy was assessed by medication count and treatment intensity score (TIS). After log-transformation and centreing of the IR indices, logistic regression models analysed associations between IR and uncontrolled 24 h ABP. Following a likelihood ratio test, restricted cubic spline (RCS) analyses were performed to model the non-linear relationship between the IR indices and the odds of uncontrolled 24 h blood pressure (BP). The cohort (mean age, 54.9 years; 58.3% male; mean BMI, 27.4 kg/m(2)) showed median values of TG/HDL-C 2.07, TyGi-BMI 234.9, TyGi-WC 832.8, LAP 41.4, VAI 71.3, and METS-IR 41. Uncontrolled ABP (64.2%) was more prevalent in younger males with higher IR indices. METS-IR and TyGi-BMI were independently associated with uncontrolled ABP.Conclusion METS-IR and TyGi-BMI were associated with uncontrolled ABP, independently of treatment status, sex, and age. These indices, derived from widely available parameters, provide practical tools for identifying patients with an increased risk of hypertension in real-life clinical settings.This study investigated the relationship between insulin resistance (IR)-a condition commonly associated with abdominal obesity-and high blood pressure (BP) in European (Italian) patients without diabetes. Researchers specifically focused on how different measures of IR, based on available anthropometric and metabolic parameters, might be associated with uncontrolled 24 h BP, as measured using a device that monitors BP throughout the day and night.Higher IR levels were associated with uncontrolled BP despite treatment.Among IR measures, METS-IR and TyGi-BMI were the most reliable predictors of uncontrolled BP.These findings are significant because the measures used to assess IR are simple and widely available. Healthcare providers could use them to identify patients at higher risk of poorly managed BP and tailor treatments accordingly.