The CHG index demonstrated the most independent association with incident hypertension, better than the AIP, TyG, and METS-IR indices in predictive accuracy.
Among 1079 adults with initially normal blood pressure followed for up to 8 years, 297 developed hypertension during follow-up.
Only the CHG index maintained a statistically independent association with hypertension risk in the fully adjusted multivariable Cox proportional hazards model.
Both the CHG index and METS-IR showed excellent and consistent discriminative capacity across initial, medium, and long-term follow-up timepoints.
The Atherogenic Index of Plasma (AIP) was the weakest predictor of incident hypertension among the four insulin resistance indices evaluated.
The four insulin resistance indices compared were the Atherogenic Index of Plasma (AIP), Triglyceride-Glucose (TyG) index, Cholesterol-HDL-Glucose (CHG) index, and Metabolic Score for Insulin Resistance (METS-IR), all derived from standard blood testing.
This research followed over 1,000 adults with normal blood pressure for up to 8 years to see which of four blood-test-based measures of insulin resistance could best predict who would go on to develop high blood pressure. The four measures — AIP, TyG index, CHG index, and METS-IR — can all be calculated from routine blood work and are thought to reflect how well the body processes sugars and fats. By the end of follow-up, about 275 participants (roughly 27%) had developed hypertension. The study found that the CHG index stood out as the strongest predictor. People with higher CHG index values had more than twice the risk of developing hypertension compared to those with lower values, even after accounting for many other health factors. Importantly, the other three measures — AIP, TyG, and METS-IR — lost their statistical significance once all confounding factors were accounted for, suggesting the CHG index captures something unique. When looking at how accurately each measure distinguished future hypertension cases from non-cases over time, the CHG index and METS-IR both performed well (with accuracy scores consistently above 0.71), while AIP performed the worst at all time points. This research suggests that the CHG index, which incorporates cholesterol, HDL, and glucose measurements, may be a particularly useful tool for identifying people at elevated risk of developing hypertension before it occurs. This could help clinicians prioritize preventive interventions for high-risk individuals using information already available from standard blood tests. The findings highlight that not all insulin resistance measures are equally useful for hypertension prediction, and that choice of index matters in clinical risk assessment.
Yang X, He Q, Zha W, Li B, Lv Q, Cao Y, et al.. (2026). Prognostic value of four insulin resistance indices in predicting new-onset hypertension: a retrospective cohort study.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1824452