Thiazide Diuretics Are Associated with a Higher Triglyceride-Glucose Index Than Calcium Channel Blockers in Hypertensive Patients
INTERNATIONAL JOURNAL OF GENERAL MEDICINE, cilt.Volume 19, ss.1-14, 2026 (SCI-Expanded)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: Volume 19
- Basım Tarihi: 2026
- Doi Numarası: 10.2147/ijgm.s640405
- Dergi Adı: INTERNATIONAL JOURNAL OF GENERAL MEDICINE
- Derginin Tarandığı İndeksler: Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Science Citation Index Expanded (SCI-EXPANDED), EMBASE, Directory of Open Access Journals
- Sayfa Sayıları: ss.1-14
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Hypertension is frequently accompanied by metabolic abnormalities that increase cardiovascular risk. The triglyceride–glucose (TyG) index is a practical surrogate marker of insulin resistance. This study aimed to compare TyG index values and relatedmetabolic parameters between patients receiving RAAS blockers plus thiazide/thiazide-like diuretics and those receiving RAASblockers plus calcium channel blockers (CCBs) as antihypertensive regimens.
Methods: In this retrospective observational study, 157 of 189 screened patients met eligibility criteria and were included (RAASblocker plus thiazide/thiazide-like diuretic, n=95; RAAS blocker plus CCB, n=62). Multivariable linear regression models and inverseprobability of treatment weighting (IPTW) analyses were performed to assess the independence of findings from clinical confounders.
Results: The TyG index was significantly higher in the diuretic group than in the CCB group [9.21 (9.01–9.73) vs 8.95 (8.66–9.40);p<0.001], as were triglyceride [186.00 vs 142.35 mg/dL; p<0.001] and uric acid levels [5.70 vs 5.00 mg/dL; p=0.004]. Blood pressurecontrol rates were similar. The treatment group effect remained significant across all adjusted models, including IPTW-weightedregression (β=0.385, p=0.0003). A significant treatment group × diabetes mellitus interaction was observed (p=0.042), suggestinga stronger association in diabetic patients. A dose-stratified analysis within the diuretic group showed a significant dose-responserelationship: higher hydrochlorothiazide (25 vs 12.5 mg/day) and indapamide (2.5 vs 1.25 mg/day) doses were both associated withsignificantly higher TyG index, fasting glucose, and uric acid levels. In an exploratory diuretic subgroup analysis, urea and BUN levelswere higher with hydrochlorothiazide than indapamide; however, this analysis was underpowered (indapamide n=24) and should beinterpreted with caution.
Conclusions: RAAS blocker plus thiazide/thiazide-like diuretic regimens were associated with a significantly higher TyG index anda less favorable metabolic profile than RAAS blocker plus CCB regimens, independent of multiple clinical confounders. Metabolicrisk profiles should be considered when selecting antihypertensive combination therapy; prospective studies are needed to establishcausality.
Keywords: hypertension, triglyceride–glucose index, insulin resistance, thiazide diuretics, calcium channel blockers