Triglyceride-Glucose, TG/HDL-C Ratio, and Lipoprotein(a) as Early Cardiovascular Risk Markers in Hypertensive Patients: Impact of Lifestyle and Pharmacological Interventions

doi:10.5281/zenodo.16786245

International Journal of Medical and Pharmaceutical Research

2025, Volume-6, Issue-4 : 440-449 doi: 10.5281/zenodo.16786245

Original Article

Triglyceride-Glucose, TG/HDL-C Ratio, and Lipoprotein(a) as Early Cardiovascular Risk Markers in Hypertensive Patients: Impact of Lifestyle and Pharmacological Interventions

Preeti Vijay Aski, Nikhil S. Aski, Nikhil N Biradar, Busi.Karunanand, Basavaraj S. Aski

DOI : 10.5281/zenodo.16786245

Published

Aug. 9, 2025

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of mortality, with diabetic dyslipidemia, hypertension, and elevated homocysteine and lipopro- tein(a) [Lp(a)] as key risk factors. The triglyceride/HDL cholesterol (TG/HDL-C) ratio and triglyceride-glucose (TyG) index are emerging cost-effective markers of insulin resistance and CVD risk.

Objective: To evaluate the impact of a 3-month lifestyle and pharmacological in- tervention on homocysteine, body mass index (BMI), glycated hemoglobin (HbA1c), postprandial glucose (PPG), lipid profiles, TG/HDL-C, TyG index, and Lp(a) in hy- pertensive patients with and without type 2 diabetes mellitus (T2DM).

Methods: A prospective cohort study was conducted from May to August 2025 at two centers in Karnataka, India, involving 300 hypertensive patients (150 di- abetic, 150 non-diabetic). Participants received a Mediterranean diet, exercise, and optimized pharmacological therapy, with monthly monitoring of glycemic, homocysteine, and Lp(a) levels. Parameters were measured using standardized assays, and data were analyzed with SPSS v26.

Results: In diabetic patients, significant reductions were observed in HbA1c (8.1% to 7.2%, p < 0.001), PPG (180 to 145 mg/dL, p < 0.001), LDL-C (130 to 105

mg/dL, p < 0.01), homocysteine (15.2 to 12.8 µmol/L, p < 0.01), BMI (31.2 to 29.8

kg/m2, p < 0.01), TG/HDL-C (4.2 to 3.5, p < 0.01), TyG index (8.9 to 8.4, p < 0.01), and

Lp(a) (45 to 38 mg/dL, p < 0.05), with increased HDL-C (40 to 48 mg/dL, p < 0.01). Non-diabetic patients showed modest improvements in BMI, LDL-C, TG/HDL-C, and Lp(a) (p < 0.05). Strong correlations in diabetic patients were noted among homocysteine, BMI, HbA1c, TG/HDL-C, TyG index, and Lp(a) (p < 0.01). TyG index (cutoff 8.5) predicted CVD risk with 78% sensitivity and 65% specificity; Lp(a) (cutoff 30 mg/dL) offered 72% sensitivity and 68% specificity. Monthly moni- toring was cost-effective ($150/patient), potentially reducing CVD hospitalization costs ($10,000/event).

Conclusions: TG/HDL-C, TyG index, and Lp(a) are robust, cost-effective CVD risk markers. Integrated management of homocysteine, BMI, and Lp(a) enhances CVD prevention in high-risk populations.

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