To investigate the effect of the triglyceride-glucose index (TyG) combined with various obesity indicators on the prevalence of comorbid hypertension and hyperuricemia among residents aged 35 years and older in Hebei province, and to provide a reference for the prevention and treatment of this comorbidity in the population.

Data from 7 859 permanent residents aged 35 years and older were collected as part of the Cardiovascular Disease and Risk Factor Surveillance Project, conducted in 10 districts/counties/cities of Hebei province between April and December 2020. A multivariable logistic regression model was used to analyze the relationship between the TyG, overweight/obesity, central obesity, and waist-to-height ratio (WHtR) with the prevalence of comorbid hypertension and hyperuricemia. The additive interaction between TyG and different obesity indicators on the prevalence of comorbid hypertension and hyperuricemia was assessed using relative excess risk due to interaction (‌RERI). The predictive value of TyG and different obesity indicators for comorbid hypertension and hyperuricemia was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Among 7 859 surveyed residents, 30.73% (2 415) were non-overweight/obese, while 69.27% (5 444) were overweight/obese; 43.80% (3 442) were non-centrally obese, and 56.20% (4 417) were centrally obese; 30.70% (2 413) had a normal WHtR, and 69.30% (5 446) had a high WHtR; 44.22% (3 475) had a low TyG (≤ 8.42), and 55.78% (4 384) had a high TyG (≥ 8.43). Additionally, 11.95% (939) had comorbid hypertension and hyperuricemia. After adjusting for sex, age, education, residence, physical activity, current smoking, alcohol consumption, and diabetes, multivariable logistic regression analysis revealed a significantly increased risk of comorbid hypertension and hyperuricemia among residents with central obesity (odds ratio [OR] = 1.676, 95% confidence interval [95%CI]: 1.346 - 2.087), overweight or obesity (OR = 1.440, 95%CI: 1.148 - 1.807), high WHtR (OR = 1.297, 95%CI: 1.001 - 1.679), and high TyG (OR = 2.335, 95%CI: 1.974 - 2.763), compared to residents who were not centrally obese, not overweight or obese, had normal WHtR, and had low TyG. The multivariable logistic regression results also showed significantly higher risks of comorbid hypertension and hyperuricemia among residents with both high TyG and high obesity indicators, including overweight or obesity (OR = 5.159, 95%CI: 3.916 - 6.796), central obesity (OR = 5.587, 95%CI: 4.357 - 7.164), and high WHtR (OR = 5.326, 95%CI: 4.038 - 7.026), compared to residents with low TyG and no overweight or obesity, no central obesity, and low WHtR, indicating an additive interaction between TyG and obesity indicators in comorbid hypertension and hyperuricemia. ROC analysis demonstrated that TyG combined with waist circumference (WC) had a higher predictive power for comorbid hypertension and hyperuricemia (AUC = 0.725, 95%CI: 0.715 - 0.735), indicating better diagnostic accuracy compared to TyG combined with body mass index (BMI), TyG combined with WHtR, or TyG alone.

High TyG, overweight/obesity, central obesity, and high WHtR are all associated with an increased risk of hypertension combined with hyperuricemia in residents aged 35 years and older in Hebei province. An additive interaction exists between TyG and different obesity indicators. TyG combined with WC could serve as an effective predictor for hypertension combined with hyperuricemia.