Cardiovascular

Association Between Cholesterol-HDL-Glucose (CHG) Index and New-Onset Hypertension Across Different Sex and Glycemic Status: A Longitudinal Study With 9-Year Follow-Up.

He H & Chen J • Endocrinology, diabetes & metabolism • 2026

TL;DR

An elevated CHG index is significantly associated with new-onset hypertension, with a positive linear relationship across sexes and glycemic statuses in a 9-year follow-up of 6555 CHARLS participants.

Key Findings

Results

A higher CHG index was significantly associated with new-onset hypertension in the overall study population.

6555 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included, with 9 years of follow-up.
Adjusted OR (95% CI) in the total population was 1.16 (1.10-1.24).
Logistic regression models were used to examine the association.

Results

The association between CHG index and new-onset hypertension was significant in both males and females, and was stronger in males.

Adjusted OR (95% CI) in males was 1.23 (1.12-1.36).
Adjusted OR (95% CI) in females was 1.12 (1.02-1.22).

Results

The association between CHG index and new-onset hypertension was significant in both prediabetic and diabetic populations.

Adjusted OR (95% CI) in the prediabetic group was 1.14 (1.01-1.29).
Adjusted OR (95% CI) in the diabetic group was 1.19 (1.03-1.36).

Results

Restricted cubic spline analysis showed a positive linear relationship between CHG index and new-onset hypertension.

The RCS analysis indicated a linear dose-response pattern rather than a threshold or non-linear pattern.

Results

Adding the CHG index or the TyG index to the basic model significantly improved prediction of hypertension.

Predictive improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Both the CHG index and the Triglyceride-Glucose (TyG) index added predictive value beyond the basic model.

What This Means

This study followed 6,555 middle-aged and older adults in China for nine years to see whether a blood-based measure called the CHG index was linked to developing high blood pressure. The index combines total cholesterol, HDL ("good") cholesterol, and blood glucose into a single number intended to reflect metabolic health. People with higher CHG index values were more likely to develop high blood pressure. The link appeared in men and women (somewhat stronger in men), and in people with prediabetes and diabetes. The relationship was roughly linear, meaning higher values were associated with progressively higher risk rather than a sudden jump at a certain level. Adding the CHG index, or the similar TyG index, to a basic prediction model also improved its ability to identify who would develop hypertension. This research suggests the CHG index could be a useful, simple marker for assessing future hypertension risk using routine blood tests. Because this is an observational study, it shows an association and cannot prove that a higher CHG index causes high blood pressure.

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Citation

He H, Chen J. (2026). Association Between Cholesterol-HDL-Glucose (CHG) Index and New-Onset Hypertension Across Different Sex and Glycemic Status: A Longitudinal Study With 9-Year Follow-Up.. Endocrinology, diabetes &amp; metabolism. https://doi.org/10.1002/edm2.70365

Key Findings

What This Means

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