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Integrating Dietary Inflammatory Index and Triglyceride-Glucose Body Mass Index for Mortality Association in Hypertension

Jianjun Wu,Youqi Zhang,N. Liu,Liu Ji,Huimin Xian,Z. Weng,Dawei Yang,Fan Yang

Published 2025 in JACC: Advances

ABSTRACT

Background Diet-related inflammation and metabolic dysfunction may influence long-term outcomes in hypertension. Objectives The objective of the study was to evaluate whether the DII (Dietary Inflammatory Index) and TyG-BMI (triglyceride-glucose body mass index), individually and jointly, are associated with cardiovascular and all-cause mortality in adults with hypertension. Methods The authors analyzed 8,024 hypertensive adults (≥18 years) from National Health and Nutrition Examination Survey 2001 to 2018 with a median follow-up of 9.91 years. DII was calculated from 27 nutrient intakes (24-hour recalls) and categorized into tertiles; TyG-BMI was derived from fasting triglycerides, fasting glucose, and BMI. Results Proinflammatory diets were associated with higher risks of cardiovascular disease (CVD) mortality (HR: 1.36; 95% CI: 1.00-1.85) and all-cause mortality (HR: 1.29; 95% CI: 1.08-1.54). Elevated TyG-BMI was associated with higher CVD mortality (HR: 1.46; 95% CI: 1.10-1.94), whereas its association with all-cause mortality was not statistically significant (HR: 1.12; 95% CI: 0.96-1.32). Participants with both high DII and high TyG-BMI had nearly a 2-fold higher risk of CVD mortality (HR: 1.98; 95% CI: 1.33-2.94). In subgroup analyses, risks appeared stronger in men (CVD HR: 2.15; 95% CI: 1.27-3.63) and among adults ≥60 years, where the highest CVD risk was observed for high DII + low TyG-BMI (HR: 1.91; 95% CI: 1.41-2.59; reference: low DII + middle TyG-BMI). Conclusions DII and TyG-BMI are significant indices that may enhance personalized strategies for CVD prevention and management.

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