Archives of medical research · 2026
Impact of the American Heart Association/American College of Cardiology Blood Pressure Classification on Insulin Resistance.
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García-García Andry J, Ruiz-Vásquez Ulises, Suárez-Aguilar Claudia, González-Pacheco Héctor, Paulino-Gonzalez Daniel, Arias-Mendoza Alexandra, Barragán-Huerta Laura, Tavera-Alonso Claudia, Lucio-García Abel, Martínez-García Mireya, Mejía-Castillo Erick U, Castillo-Martínez Diana, Gutiérrez-Esparza Guadalupe O, Amezcua-Guerra Luis M
Аннотация
BACKGROUND: The 2025 American Heart Association (AHA)/American College of Cardiology (ACC) blood pressure (BP) guidelines modified diagnostic thresholds, expanding the population classified as hypertensive and enabling earlier identification of individuals with subclinical metabolic dysfunction.
AIM: To evaluate whether insulin resistance (IR), assessed using the triglyceride-glucose (TyG) index -a validated surrogate marker of IR- differs across the 2025 AHA/ACC BP categories in adults previously considered normotensive according to the Eighth Joint National Committee (JNC-8) definition.
METHODS: We conducted a cross-sectional analysis of 3,235 clinically healthy adults (age 37 ± 9 years; 63% women) with BP <140/90 mmHg and fasting glucose ≤125 mg/dL. BP was categorized as normal (<120/80 mmHg), elevated (120-129/<80 mmHg), or stage 1 hypertension (130-139/80-89 mmHg) according to the 2025 AHA/ACC criteria.
RESULTS: Reclassification identified 2,469 (76.3%) individuals with normal BP, 123 (3.8%) with elevated BP, and 643 (19.9%) with stage 1 hypertension. Mean TyG values increased progressively across BP categories (4.64 ± 0.27; 4.76 ± 0.27; 4.80 ± 0.28, respectively; p <0.001). Correspondingly, IR prevalence rose from 41% to 63% and 64% (p <0.001). IR prevalence was more pronounced in men than in women. Associations between BP categories and both TyG values and IR persisted after multivariate adjustment.
CONCLUSIONS: Among clinically healthy adults, the 2025 AHA/ACC BP thresholds identify subgroups with substantially higher metabolic burden. Incremental increases in BP, previously considered within normal ranges according to JNC-8 criteria, are associated with IR.
AIM: To evaluate whether insulin resistance (IR), assessed using the triglyceride-glucose (TyG) index -a validated surrogate marker of IR- differs across the 2025 AHA/ACC BP categories in adults previously considered normotensive according to the Eighth Joint National Committee (JNC-8) definition.
METHODS: We conducted a cross-sectional analysis of 3,235 clinically healthy adults (age 37 ± 9 years; 63% women) with BP <140/90 mmHg and fasting glucose ≤125 mg/dL. BP was categorized as normal (<120/80 mmHg), elevated (120-129/<80 mmHg), or stage 1 hypertension (130-139/80-89 mmHg) according to the 2025 AHA/ACC criteria.
RESULTS: Reclassification identified 2,469 (76.3%) individuals with normal BP, 123 (3.8%) with elevated BP, and 643 (19.9%) with stage 1 hypertension. Mean TyG values increased progressively across BP categories (4.64 ± 0.27; 4.76 ± 0.27; 4.80 ± 0.28, respectively; p <0.001). Correspondingly, IR prevalence rose from 41% to 63% and 64% (p <0.001). IR prevalence was more pronounced in men than in women. Associations between BP categories and both TyG values and IR persisted after multivariate adjustment.
CONCLUSIONS: Among clinically healthy adults, the 2025 AHA/ACC BP thresholds identify subgroups with substantially higher metabolic burden. Incremental increases in BP, previously considered within normal ranges according to JNC-8 criteria, are associated with IR.