Association between the single-point insulin sensitivity estimator and cardiovascular disease incidence: A prospective nationwide cohort study involving two cohorts.

Previous studies found that frailty was an important risk factor for cardiovascular disease (CVD). However, previous studies only focused on baseline frailty status, not taking into consideration the changes in frailty status during follow-up. The aim of this study was to investigate the associations of changes in frailty status with incident CVD. This study used data of three prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS), English Longitudinal Study of Ageing (ELSA), and Health and Retirement Study (HRS). Frailty status was evaluated by the Rockwood frailty index and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by frailty status at baseline and the second survey which was two years after the baseline. Cardiovascular disease was ascertained by self-reported physician-diagnosed heart disease (including angina, heart attack, congestive heart failure, and other heart problems) or stroke. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) after adjusting for potential confounders. A total of 7116 participants from CHARLS (female: 48.6%, mean age: 57.4 years), 5303 from ELSA (female: 57.7%, mean age: 63.7 years), and 7266 from HRS (female: 64.9%, mean age: 65.1 years) were included according to inclusion and exclusion criteria. The median follow-up periods were 5.0 years in the CHARLS, 10.7 years in the ELSA, and 9.5 years in the HRS. Compared with stable robust participants, robust participants who progressed to pre-frail or frail status had increased risks of incident CVD (CHARLS, HR = 1.84, 95% CI: 1.54-2.21; ELSA, HR = 1.53, 95% CI: 1.25-1.86; HRS, HR = 1.59, 95% CI: 1.31-1.92). In contrast, frail participants who recovered to robust or pre-frail status presented decreased risks of incident CVD (CHARLS, HR = 0.62, 95% CI: 0.47-0.81; ELSA, HR = 0.49, 95% CI: 0.34-0.69; HRS, HR = 0.70, 95% CI: 0.55-0.89) when compared with stable frail participants. These decreased risks of incident CVD were also observed in pre-frail participants who recovered to robust status (CHARLS, HR = 0.66, 95% CI: 0.52-0.83; ELSA, HR = 0.65, 95% CI: 0.49-0.85; HRS, HR = 0.71, 95% CI: 0.56-0.91) when compared with stable pre-frail participants. Different changes in frailty status are associated with different risks of incident CVD. Progression of frailty status increases incident CVD risks, while recovery of frailty status decreases incident CVD risks.

Baseline and changes in cardiometabolic index and incident cardiovascular disease in two prospective cohorts

Background: Elevated triglyceride-glucose (TyG) related indices, such as TyG-body mass index, TyG-waist-to-height ratio, TyG-waist circumference was associated with higher risk of cardiovascular disease (CVD). Body roundness index (BRI) is superior to traditional anthropometric indices in predicting metabolic syndrome. However, the association between the TyG-BRI, as a new metabolic indicator, and CVD incidence and whether its predicting effect of CVD incidence is better than other TyG related indices remains unknown. Method: The datasets analyzed in our study were derived from two nationally representative prospective cohort studies: English Longitudinal Study of Ageing (ELSA) and China Health and Retirement Longitudinal Study (CHARLS). TyG was calculated as ln [TG (mg/dL) × FBG (mg/dL)/2]; The TyG-BRI index is determined by TyG index * BRI index. The participants were classified into four groups (Q1, Q2, Q3, and Q4) by the quartiles of TyG-BRI index. We performed Cox proportional hazards models after adjusting for potential confounders to analyze the association between the TyG-BRI index and CVD incidence. Restricted cubic spline models (RCS) were used to explore the non-linear relationship between TyG-BRI and CVD incidence. Receiver operating characteristic (ROC) curve analysis to evaluate and compare the predictive performance of TyG-BRI and TyG-related indices for CVD assessment Results: A total of 3,256 participants from ELSA (female: 54.0%, age more than 60: 63.7%) and 8,323 participants from CHARLS (female: 53.5%, age more than 60: 41.6%) were included in the analysis. The median follow-up periods were 12 years in the ELSA and 7 years in the CHARLS. After adjusting for potential confounding factors, the highest TyG-BRI group (Q4) had an increased risk of CVD compared with the Q1 group. (ELSA, HR 1.81, 95% CI 1.09–2.98; CHARLS, HR 1.57, 95% CI 1.32–1.87). An inverted U-shaped association was identified between TyG-BRI and CVD during the examination of nonlinear relationships (both P <0.05). TyG - BRI has a higher AUC of 0.557 (95% CI: 0.531 - 0.583) in ELSA and AUC of 0.581 (95% CI: 0.565 - 0.596) in CHARLS than other TyG-related indices in predicting CVD incidence. Conclusions: Elevated TyG-BRI levels was associated with higher risk of incident CVD. TyG-BRI offers a new tool for early risk identification, and TyG-BRI had a better predictive ability than other TyG- related indices in predicting CVD incidence.

Statin Therapy Is Associated with Reduced Clonal Expansion in TET2 Mutated Clonal Haematopoiesis of Indeterminate Potential

APOL1 renal risk variants are strongly associated with chronic kidney disease in Black adults, but reported associations with cardiovascular disease (CVD) have been conflicting. We examined associations of APOL1 with incident coronary heart disease (n=323), ischemic stroke (n=331), and the composite CVD outcome (n=500) in 10 605 Black participants of the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Primary analyses compared individuals with APOL1 high-risk genotypes to APOL1 low-risk genotypes in Cox proportional hazards models adjusted for CVD risk factors and African ancestry. APOL1 high-risk participants were younger and more likely to have albuminuria at baseline than APOL1 low-risk participants. The risk of incident stroke, coronary heart disease, or composite CVD end point did not significantly differ by APOL1 genotype status in multivariable models. The association of APOL1 genotype with incident composite CVD differed by diabetes mellitus status (Pinteraction=0.004). In those without diabetes mellitus, APOL1 high-risk genotypes associated with greater risk of incident composite CVD (hazard ratio, 1.67; 95% confidence interval, 1.12-2.47) compared with those with APOL1 low-risk genotypes in multivariable adjusted models. This latter association was driven by ischemic strokes (hazard ratio, 2.32; 95% confidence interval, 1.33-4.07), in particular, those related to small vessel disease (hazard ratio, 5.10; 95% confidence interval, 1.55-16.56). There was no statistically significant association of APOL1 genotypes with incident CVD in subjects with diabetes mellitus. The APOL1 high-risk genotype was associated with higher stroke risk in individuals without but not those with chronic kidney disease in fully adjusted models. APOL1 high-risk status is associated with CVD events in community-dwelling Black adults without diabetes mellitus.

Background There is increasing evidence of an association between social relationships and morbidity in general, and cardiovascular disease in particular. However, recent syntheses of the evidence raise two important questions: is it the perceived quality or the more objective quantity of relationships that matters most; and what are the implications of changes in relationships over time? In this study, we investigate the cumulative effects of loneliness and social isolation on incident cardiovascular disease. Design A secondary analysis of prospective follow-up data from the English Longitudinal Study of Ageing (ELSA). Methods To assess the association between social isolation or loneliness and incident cardiovascular disease, lagged values of exposure to loneliness and isolation were treated as time-varying variables in discrete time survival models controlling for potential confounders and established cardiovascular disease risk factors. Results A total of 5397 men and women aged over 50 years were followed up for new fatal and non-fatal diagnoses of heart disease and stroke between 2004 and 2010. Over a mean follow-up period of 5.4 years, 571 new cardiovascular events were recorded. We found that loneliness was associated with an increased risk of cardiovascular disease (odds ratio 1.27, 95% confidence interval 1.01-1.57). Social isolation, meanwhile, was not associated with disease incidence. There was no evidence of a cumulative effect over time of social relationships on cardiovascular disease risk. Conclusions Loneliness is associated with an increased risk of developing coronary heart disease and stroke, independently of traditional cardiovascular disease risk factors. Our findings suggest that primary prevention strategies targeting loneliness could help to prevent cardiovascular disease.

BackgroundAtherogenic index of plasma (AIP) at baseline has been associated with increased morbidity and mortality from cardiovascular disease (CVD). However, the relationship between long-term AIP trajectories and CVD remains unclear. Therefore, this study aimed to investigate the associations between AIP trajectories and the incidence of CVD in the English population.MethodThe study data analysis was based on the English Longitudinal Study of Aging (ELSA) from 2004 to 2017. The study population consisted of individuals aged 50 years and older in England. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Group-based trajectory model (GBTM) was applied to identify the trajectory of the AIP index from Wave 2 to 8 over a 12-year follow-up. Cox proportional hazard models were then used to analyze the associations between different AIP index trajectory groups and the incidence of CVD.ResultsA total of 3976 participants with completed AIP data in Wave 2 and more than two AIP measurements between Wave 2 and Wave 8 were enrolled in the ELSA cohort. The participants were divided into three groups [low-stable group (n = 1146), moderate-stable group (n = 2110), high-stable group (n = 720)] using a GBTM model. After adjusting for potential confounders, participants in the high-stable group indicated an increased risk of developing incident of CVD compared to those in the low-stable AIP group [Hazard Ratio (HR) 1.33; 95% Confidence Interval (CI) 1.02–1.74, P = 0.033]. However, no differences in the incidence of CVD (HR 1.20, 95%CI 0.98–1.48, P = 0.082) were observed in the moderate-stable group. Subgroup analysis indicated similar results for participants under 63 years old and those with high alcohol consumption.ConclusionsA high and sustainable level of the AIP index may contribute to the incidence of CVD. The trajectories of the AIP index can help identify older English individuals at increased risk of CVD who deserve primitive preventive and therapeutic approaches.

BackgroundHigh blood pressure (HBP) is a major risk factor for cardiovascular disease (CVD), the leading cause of mortality worldwide. Short‐term clinical trials have found beneficial effects of higher dairy intakes, especially yogurt, on CVD risk among those with HBP. However, long‐term studies are lacking.ObjectiveTo estimate the independent effects of total dairy and yogurt on risk of incident CVD among middle‐aged adults with HBP. Secondarily, possible effect modification by a healthy diet pattern was explored.MethodsSubjects included 57,768 30–55 year‐old women in the Nurses' Health Study (NHS) and 18,593 40–75 year‐old men in the Health Professionals Follow‐Up Study (HPFS) who reported HBP. Subjects with prevalent CVD, diabetes, or cancer were excluded. Cumulative average dairy intakes were derived from validated, semi‐quantitative food frequency questionnaires every 4 years. CVD, defined as myocardial infarction (MI) or stroke, was ascertained via self‐report with medical record review. NHS and HPFS subjects were followed for incident CVD for up to 30 and 24 years, respectively from the time of first reported HBP diagnosis. Time dependent Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) while controlling for age, race, family history of HBP or MI, BP medication use, smoking, alcohol, physical activity, BMI, and intakes of energy, fiber and trans fats. A DASH (Dietary Approaches to Stop Hypertension) diet score was calculated to explore effect modification by diet quality.ResultsThere were 5,468 total CVD cases in both cohorts, with 3,678 and 1,790 incident CVD cases in the NHS and HPFS, respectively. Of the 3,678 CVD cases in NHS, 1,887 were MI events and 1,791 strokes. In HPFS, there were 1,267 MI events and 523 incident strokes. Yogurt intake was inversely associated with risk of CVD among those with prevalent HBP (p for linear trend <0.01 for both NHS and HPFS). Participants who consumed yogurt twice or more weekly in the NHS and HPFS had 17% (95% CI: 0.75–0.92) and 18% (95% CI: 0.68–0.97) reductions on risk of CVD, respectively. The effect of yogurt was further modified by a healthy diet pattern (as measured by a DASH score). Regular yogurt consumers in the NHS (≥2 servings/week) and HPFS (≥1 serving/week) with higher DASH scores (≥25 for both cohorts) had 19% (95% CI: 0.71–0.92) and 31% (95% CI: 0.57–0.83) lower risks of CVD, respectively. Total dairy intake was inversely associated with CVD risk among men. Finally, for participants in both NHS and HPFS whose diet more closely matched that of a DASH diet (DASH score ≥22), consuming ≥1 serving/day of dairy led to 12% (95% CI: 0.79–0.97) and 16% (95% CI: 0.73–0.97) lower risks of CVD, respectively.ConclusionHigher usual yogurt intakes were associated with lower risks of incident CVD in both women and men with prevalent HBP. Total dairy intake was particularly beneficial for men with HBP. When combined with a higher DASH score, higher total dairy and yogurt intakes led to meaningful reductions in CVD risk in both cohorts. These results suggest that incorporation of yogurt into a healthy diet pattern in hypertensive adults may provide a valuable non‐pharmacological approach to CVD prevention.Support or Funding InformationNational Dairy Council and the Boston Nutrition Obesity Research Center

BACKGROUNDDepression is a significant risk factor for diabetes, particularly type 2 diabetes. However, depressive symptoms differ from clinical depression. Previous research has not fully considered the relationship between the trajectory of depressive symptoms and the risk of developing diabetes over time.AIMTo investigate the association between depressive symptoms, their trajectories, and the risk of developing diabetes in two prospective cohort studies.METHODSIn the first phase we analyzed the association between depressive symptoms and the risk of developing diabetes separately using the Health and Retirement Study (HRS). Depressive symptom trajectories were assessed by examining changes in depressive symptoms at baseline and again 8 years later. We then identified specific depressive symptom trajectories that increased the risk of diabetes in the second phase. Finally, we confirmed the association between depressive symptoms and their trajectories with diabetes risk using the English Longitudinal Study of Ageing (ELSA) as a validation study. Depressive symptom trajectories were categorized into five states based on changes in the modified 8-item Center for Epidemiological Studies-Depression scores: Persistently high; increasing; fluctuating; decreasing; and persistently low. Diabetes mellitus was defined as self-reported, physician-diagnosed diabetes. Cox proportional hazards models were used to assess hazard ratios (HR) and 95% confidence intervals (CI), adjusting for potential confounders.RESULTSIn the first phase a total of 27658 participants were included (HRS: 18633, ELSA: 9025), among whom 6582 had depressive symptoms (HRS: 4547, ELSA: 2035), 6407 had somatic depressive symptoms (HRS: 4414, ELSA: 1993), and 26415 had cognitive-affective depressive symptoms (HRS: 17755, ELSA: 8660). We found that overall depressive symptoms (HRS: HR = 1.14, 95%CI: 1.07-1.22; ELSA: HR = 1.18, 95%CI: 1.03-1.34) and somatic depressive symptoms (HRS: HR = 1.14, 95%CI: 1.07-1.22; ELSA: HR = 1.25, 95%CI: 1.10-1.42) increased the risk of diabetes, while cognitive depressive symptoms were not associated with diabetes risk. Over an 8-year follow-up we identified 19729 trajectories of overall, somatic, and cognitive-affective depressive symptoms (HRS: 13918, ELSA: 5811). In the second phase we found that persistently high (HRS: HR = 1.22, 95%CI: 1.06-1.40, ELSA: HR = 1.54, 95%CI: 1.16-2.05 in total and HRS: HR = 1.24, 95%CI: 1.07-1.43, ELSA: HR = 1.79, 95%CI: 1.36-2.35 in somatic) and fluctuating (HRS: HR = 1.09, 95%CI: 1.01-1.17, ELSA: HR = 1.33, 95%CI: 1.14-1.55 in total and HRS: HR = 1.10, 95%CI: 1.02-1.18, ELSA: HR = 1.31, 95%CI: 1.13-1.53 in somatic) trajectories of overall and somatic depressive symptoms increased the risk of diabetes, while increasing trajectories may also raise diabetes risk. However, decreasing trajectories were not associated with diabetes risk. Cognitive-affective depressive symptoms showed no association with diabetes risk regardless of trajectory changes. Sensitivity analyses confirmed the reliability of the findings.CONCLUSIONPersistently high and fluctuating trajectories of overall and somatic depressive symptoms increased the risk of diabetes, while decreasing trajectories were not associated with diabetes risk. In contrast trajectories of cognitive-affective depressive symptoms show no relationship with diabetes risk. Focusing on depressive symptom trajectories, particularly those of somatic depressive symptoms, represented a viable strategy for future diabetes prevention.

Dietary habits, particularly staple food consumption, play a significant role in influencing cardiovascular disease (CVD) risk. However, limited research has examined the relationship between staple food types and CVD incidence in aging populations, especially in China. This study aims to identify which types of staple foods are most beneficial for cardiovascular health among older Chinese adults. Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed to explore the associations between staple food types (rice, wheat, and coarse cereals) and CVD risk among 16,498 adults aged 65 and older. Cox proportional hazards models were employed to evaluate the relationship between staple food types and CVD incidence, while restricted cubic splines assessed potential non-linear relationships between staple food intake and CVD risk. Stratified analyses were performed based on age, sex, and hypertension history. During a median follow-up of 7.38 years, 1757 participants experienced new-onset CVD. Wheat as a staple food was related to a 40.8% higher risk of CVD compared to rice (HR: 1.408; 95% CI: 1.195-1.658; p < 0.001), while no significant association was observed for coarse cereals. Stratified analyses revealed that the association with wheat was stronger among participants aged 65-79 years, males, and those without hypertension. No linear relationship was found between intake levels of rice, wheat, or coarse cereals and CVD risk, but non-linear associations emerged for rice and wheat intake (P for non-linear association<0.001 and = 0.010, respectively). A U-shaped relationship was observed for wheat, with the lowest CVD risk at a cooked intake of 375 g/day, consistent with dietary guidelines. This study highlights the differential impact of staple food types on CVD risk, with wheat consumption linked to a higher incidence of CVD compared to rice, particularly in specific subgroups. These findings provide evidence to inform dietary guidelines for older Chinese adults and underscore the need for further research into the underlying mechanisms.

BackgroundThe association of APOE genotype with circulating apolipoprotein E (ApoE) concentration and cardiovascular disease (CVD) risk is well established. However, the relationship of circulating ApoE concentration and CVD has received little attention.Methods and FindingsTo address this, we measured circulating ApoE concentration in 9,587 individuals (with 1,413 CVD events) from three studies with incident CVD events: two population-based studies, the English Longitudinal Study of Ageing (ELSA) and the men-only Northwick Park Heart Study II (NPHSII), and a nested sub-study of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). We examined the association of circulating ApoE with cardiovascular risk factors in the two population-based studies (ELSA and NPHSII) and the relationship between ApoE concentration and coronary heart disease and stroke in all three studies. Analyses were carried out within study, and, where appropriate, pooled effect estimates were derived using meta-analysis. In the population-based samples, circulating ApoE was associated with systolic blood pressure (correlation coefficient 0.08, p < 0.001, in both ELSA and NPHSII), total cholesterol (correlation coefficient 0.46 and 0.34 in ELSA and NPHSII, respectively; both p < 0.001), low-density lipoprotein cholesterol (correlation coefficient 0.30 and 0.14, respectively; both p < 0.001), high-density lipoprotein (correlation coefficient 0.16 and −0.14, respectively; both p < 0.001), and triglycerides (correlation coefficient 0.43 and 0.46, respectivly; both p < 0.001). In NPHSII, ApoE concentration was additionally associated with apolipoprotein B (correlation coefficient 0.13, p = 0.001) and lipoprotein(a) (correlation coefficient −0.11, p < 0.001). In the pooled analysis of ASCOT, ELSA, and NPHSII, there was no association of ApoE with CVD events; the odds ratio (OR) for CVD events per 1-standard-deviation higher ApoE concentration was 1.02 (95% CI 0.96, 1.09). After adjustment for cardiovascular risk factors, the OR for CVD per 1-standard-deviation higher ApoE concentration was 0.97 (95% CI 0.82, 1.15). Limitations of these analyses include a polyclonal method of ApoE measurement, rather than isoform-specific measurement, a moderate sample size (although larger than any other study to our knowledge and with a long lag between ApoE measures), and CVD events that may attenuate an effect.ConclusionsIn the largest study to date on this question, we found no evidence of an association of circulating ApoE concentration with CVD events. The established association of APOE genotype with CVD events may be explained by isoform-specific functions as well as other mechanisms, rather than circulating concentrations of ApoE.

Although sleep duration and weight-adjusted waist index (WWI) are recognized cardiovascular disease (CVD) risk factors in older adults, the individual and dual trajectories of these factors and their associations with CVD risk remain unclear. We aim to investigate these associations using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We included 3313 older adults without hypertension, heart disease, or stroke in 2011 and assessed sleep duration, WWI, and CVD incidence in 2011, 2014, and 2018. Group-based dual trajectory modelling and logistic regression were used for analysis. All data were analysed in 2024. Three trajectories of sleep duration (low-stable, normal-stable, high-increasing) and two trajectories of WWI (normal-increasing, high-increasing) were identified, along with their six dual trajectories. Compared to the 'normal-increasing WWI and normal-stable sleep duration' pattern, the 'high-increasing WWI and low-stable sleep duration' pattern was associated with an increased risk of any one type of CVD [odds ration (OR) = 1.25, 95% confidence interval (CI) 1.03-1.83], the 'normal-increasing WWI and low-stable sleep duration' pattern was associated with an increased risk of any two types of CVD (OR = 1.58, 95% CI 1.06-2.36), and the 'normal-increasing WWI and high-increasing sleep duration' pattern was associated with an increased risk of all three types of CVD (OR = 4.48, 95% CI 1.44-13.94). These findings highlight the importance of nursing professionals considering both sleep duration and WWI trajectories when assessing CVD risk in older adults, supporting the implementation of multi-point monitoring and targeted joint interventions to mitigate CVD risk in this population.

The triglyceride-glucose (TyG) index has been recognized as a surrogate marker for insulin resistance (IR) and an independent risk factor for cardiovascular disease (CVD). However, the combined effect of the TyG index and visceral obesity on CVD incidence remains unclear. We aimed to investigate the interaction, joint association, and potential mediators between the TyG index and comprehensive anthropometric indices with CVD risk in middle-aged and older adults. We analyzed 7046 participants aged ≥ 45years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS) over a 9-year follow-up period. Retrospective collection included sociodemographic details, health status, physical examination results, and blood biomarkers. Adjusted Cox proportional hazards models were used to examine the interaction between TyG levels and anthropometric indices and their joint associations with CVD incidence. Subgroup analyses were conducted to evaluate the associations across different populations, and mediation analysis was performed to identify potential mediating pathways. The predictive value was determined using the area under the curve (AUC) of receiver operating characteristic curves. In addition, we validated the findings in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. In the CHARLS study, 1768 (25.1%) participants developed CVD. All TyG-anthropometric indices exhibited significant positive associations with the incidence of CVD. TyG-waist-to-height ratio (WHtR) showed the strongest association, with each 1-SD increase correlating with a 25% increase in CVD risk. Elevated systolic and diastolic blood pressure (BP) levels partially mediated these associations. TyG-weight-adjusted waist index (WWI) indicated the highest predictive performance in CHARLS, while TyG-conicity index (ConI) was the most predictive in the MESA cohort. Across both cohorts, TyG-WHtR provided the most substantial incremental improvement to the baseline model. Models combining TyG-anthropometric indices showed higher prediction accuracy and goodness of fit than the basic model combining TyG or anthropometric indices alone. Decision curve analysis showed that TyG-WC and TyG-ConI yielded the superior net clinical benefits for CVD prediction. Subgroup analyses demonstrated consistent associations between TyG-anthropometric indices and CVD incidence across different clinical characteristics and sociodemographic groups. The integration of TyG with anthropometric indices strengthened its association with CVD incidence. While TyG-WWI and TyG-ConI exhibited the highest predictive ability in the CHARLS and MESA cohorts, respectively, TyG-WHtR consistently yielded the greatest improvement to traditional risk models. Elevated BP levels partially mediated this association. Early intervention targeting visceral adiposity and impaired insulin sensitivity is crucial for mitigating CVD incidence in middle-aged and older adults.

Preeclampsia: Exposing Future Cardiovascular Risk in Mothers and Their Children

BackgroundThe impact of triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, on the risk of cardiovascular disease (CVD) in general populations remains controversial. We aimed to comprehensively study the relationship between TyG index with the risk of incident CVD events in the general population in Shanghai.MethodsA total of 42,651 participants without previous history of CVD events from Shanghai Suburban Adult Cohort and Biobank (SSACB) were included. SSACB was a community-based natural population cohort study using multistage cluster sampling method. TyG index was calculated as Ln [fasting serum triglyceride (mg/dL) * fasting blood glucose (mg/dL)/2]. Kaplan-Meier curves, log-rank test and cox proportional hazards model were used to calculate the association between TyG index and incident CVD, including stroke and coronary heart disease (CHD). Restricted cubic spline analyses were used to determine whether there was a non-linear relationship between TyG index and CVD events.ResultsDuring a median follow-up of 4.7 years, 1,422 (3.3%) individuals developed CVD, including 674 (1.6%) cases of stroke and 732 (1.7%) cases of CHD. A one unit increment higher TyG index was associated with [HR(95%CI)] 1.16(1.04–1.29) in CVD and with 1.39(1.19–1.61) in stroke. Only linear relationships between TyG and CVD/stroke were observed, while no relationship was observed with CHD after adjustments for confounders. In subgroup analyses, younger (< 50y) and diabetic participants had higher risk of CVD than their counterpart groups, while hypertensive and dyslipidemic participants depicted lower risks than their counterparts.ConclusionElevated TyG index was associated with a higher risk of incident CVD and stroke. TyG index may help in the early stage of identifying people at high risk of CVD.