Abstract
The triglyceride-glucose body mass index (TyG-BMI) is an emerging composite metabolic indicator in cardiovascular research. However, the link between TyG-BMI and target organ damage (TOD) in essential hypertension (EH) remains uncertain. This study investigated the association between TyG-BMI and TOD in patients with EH. We conducted a retrospective cohort study involving 493 individuals with EH. Participants were divided at the cohort-specific median into high and low TyG-BMI groups. Over a median follow-up of 23 months, 191 participants experienced TOD. Kaplan-Meier curves showed a significantly higher cumulative incidence of TOD in the high TyG-BMI group than in the low TyG-BMI group (p < 0.05). In multivariable logistic regression, TyG-BMI remained an independent correlate of TOD (adjusted OR = 1.83, 95% CI: 1.08-3.10; p < 0.05). Least absolute shrinkage and selection operator-Cox regression further selected TyG-BMI, age, and smoking status as key predictors of TOD. Subgroup analyses revealed that the TyG-BMI-TOD association was stronger among younger or middle-aged, normal-weight, non-diabetic, non-smoking subjects (p < 0.05). Finally, the TyG-BMI-based model achieved predictive accuracy comparable to that of a conventional risk-factor model. In conclusion, TyG-BMI is independently associated with TOD in EH patients. Its predictive value closely mirrors that of combined traditional risk factors, highlighting TyG-BMI as a promising clinical marker.