Background: The triglyceride-glucose (TyG) index has emerged as a simple surrogate marker for insulin resistance and cardiovascular risk. However, its association with hypertension remains understudied in clinical populations using multiple diagnostic definitions.

Objective: To assess the association between TyG index and hypertension risk in adults and compare how different hypertension diagnostic criteria affect this relationship.

Methods: A cross-sectional study was conducted among 450 adults attending SLN Medical College and Hospital, Koraput, over a 4-month period. Fasting triglyceride and glucose levels were used to compute the TyG index. Blood pressure was measured using standardized procedures. Hypertension was defined using both ACC/AHA (≥130/80 mmHg) and JNC-8 (≥140/90 mmHg) guidelines. Participants were categorized into TyG quartiles. Logistic and linear regression models assessed associations with hypertension and blood pressure, adjusting for age, body mass index (BMI), and smoking status.

Results: Hypertension prevalence (ACC/AHA) increased from 9.7% in the lowest TyG quartile to 26.8% in the highest (p = .0368). Logistic regression showed TyG Index significantly predicted hypertension (OR = 2.47; 95% CI: 0.24–1.57; p = .0075). In multivariable linear regression, TyG was independently associated with systolic blood pressure (β = 3.16; p = .0060), but not with diastolic pressure. Model fit was strong (Nagelkerke R² = 1.000).

Conclusion: Higher TyG Index levels are significantly associated with increased risk of hypertension and elevated systolic blood pressure. The TyG Index may serve as a practical, non-invasive biomarker for early hypertension screening and risk stratification.