Higher baseline TyG index and fatty liver were associated with increased risk of new-onset hypertension, and baseline fatty liver significantly modified the association between TyG index and new-onset hypertension (P for interaction <0.001).
Higher TyG index was independently associated with new-onset hypertension as a continuous variable.
Participants in the highest TyG quartile had a significantly greater risk of new-onset hypertension compared to those in the lowest quartile.
13,949 participants (20.9%) developed new-onset hypertension during the follow-up period.
Participants with both high TyG index and fatty liver had the highest risk of new-onset hypertension.
Fatty liver status significantly modified the association between TyG index and new-onset hypertension.
The associations between TyG index, fatty liver, and new-onset hypertension remained materially unchanged in sensitivity analyses.
This research suggests that a simple blood test-based marker called the triglyceride-glucose (TyG) index — which reflects how well the body handles insulin — is linked to the future development of high blood pressure. In a study of over 66,000 adults who had routine health checkups and were followed for about 2.4 years, roughly 1 in 5 participants developed high blood pressure. Those with higher TyG index values at the start of the study were significantly more likely to develop hypertension, with the highest-risk group being about 61% more likely to develop it compared to those with the lowest TyG values. The study also found that having fatty liver disease (detected by ultrasound) plays an important role in this relationship. People who had both a high TyG index and fatty liver at the start of the study faced the greatest risk of developing hypertension — about 63% higher than the reference group. Importantly, fatty liver status changed how strongly TyG predicted hypertension risk, meaning the two conditions together appear to have a compounding effect rather than simply adding together independently. This research suggests that routinely measuring the TyG index during health checkups could help identify people at higher risk of developing high blood pressure, and that knowing whether someone also has fatty liver may help refine that risk estimate. Since both the TyG index and fatty liver can be detected through standard health screenings (blood tests and ultrasound), these findings could be practically useful in identifying people who might benefit from earlier lifestyle or medical interventions, though further research would be needed to determine whether treating these conditions reduces hypertension risk.
Lin Y, Wu L, Yan S, Sun R. (2026). Effect modification by fatty liver in the association between triglyceride-Glucose index and new-onset hypertension: a large health-examination cohort study.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1897050