Abstract
This study aimed to investigate the associations of the C-reactive protein-triglyceride glucose index (CTI) and the triglyceride-glucose (TyG) index with prehypertension and hypertension in a Chinese population aged 45 years and older. Based on blood pressure diagnostic criteria, 8389 eligible participants were categorized into three groups. In the multivariate logistic regression analysis, after adjusting for potential confounders (Model 2), individuals in the highest quartiles (Q4) of both indices exhibited a significantly increased risk of hypertension compared to those in the lowest quartiles (Q1). Specifically, the adjusted odds ratios (ORs) for Q4 were 1.592 (95% CI: 1.354-1.872) for the TyG index and 1.588 (95% CI: 1.356-1.860) for CTI. A similar independent association was observed for prehypertension. Notably, the CTI demonstrated an enhanced responsiveness in identifying hypertension at lower exposure levels, maintaining a significant association in the second quartile (Q2 OR: 1.201, 95% CI: 1.034-1.395). Furthermore, RCS analysis revealed a more pronounced non-linear dose-response relationship for CTI (P-non-linear < 0.001) than for TyG (P-non-linear = 0.045). Both CTI and the TyG index are independent indicators of prehypertension and hypertension in middle-aged and elderly Chinese adults. Although their standalone discriminatory power is modest (AUC ≈ 0.59), CTI may serve as a supplementary and cost-effective monitor for the early risk stratification of hypertension, given its responsiveness to non-linear risk transitions.