Introduction: Metabolic score for insulin resistance (METS-IR) is a promising and reliable non-insulin-based method for assessing insulin resistance and cardiovascular disease risk. Through cross-sectional and longitudinal analyses, we evaluated the predictive ability of METS-IR for hypertension risk, aiming to provide a basis for early screening and intervention strategies to reduce hypertension-related complications.

Methods: Data were utilized from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45 and above with complete METS-IR and self-reported hypertension records. A combination of cross-sectional (waves 1 and 3) and longitudinal designs was used to track hypertension incidence, with 10,738 participants in the cross-sectional analysis and 6,788 participants in the longitudinal analysis. Data collection included health behaviors, physical measurements, and blood tests. METS-IR was calculated using a standardized formula, and hypertension was defined according to established criteria. Statistical analyses assessed associations, with a significance level set at p < 0.05.

Results: The cross-sectional analysis, after adjusting for confounders, showed that each unit increase in METS-IR was associated with a threefold increase in the risk of hypertension (adjusted OR = 3.48, 95% CI: 2.87, 4.21, P < 0.0001). A significant nonlinear relationship between METS-IR and hypertension risk was observed, particularly beyond a value of 2.0, where the risk significantly increased. Subgroup analysis revealed that smoking and sex significantly affected this association. Longitudinal analysis demonstrated that each unit increase in METS-IR was significantly associated with increased hypertension incidence at 2 years (OR = 1.54, 95% CI: 1.09, 2.18, P < 0.05), 5 years (OR = 1.52, 95% CI: 1.17, 1.97, P < 0.05), and 7 years (OR = 1.71, 95% CI: 1.38, 2.12,, P < 0.0001), respectively.

Conclusion: Using CHARLS data, we found that higher METS-IR independently predicts hypertension incidence and prevalence in Chinese older adults.

Keywords: Hypertension; Incidence; Mets-IR; Prevalence.

© 2025. The Author(s).

简介： 代谢评分法（METS-IR）是一种有前途且可靠的非胰岛素基方法，用于评估胰岛素抵抗和心血管疾病风险。通过横断面分析和纵向研究，我们评估了METS-IR对高血压风险的预测能力，旨在为早期筛查和干预策略提供基础，以减少与高血压相关的并发症。

方法： 数据来自中国健康与退休追踪调查（CHARLS），涉及45岁及以上且具备完整METS-IR和自我报告高血压记录的参与者。采用横断面（第1波和第3波）及纵向设计相结合的方法，跟踪高血压发生率，其中横断面分析包括10,738名参与者，纵向分析包括6,788名参与者。数据收集包括健康行为、体格测量和血液检测。METS-IR根据标准公式计算得出，高血压的定义依照既定标准确定。统计分析评估关联性，并将显著水平设定为p

结果： 横断面分析显示，在调整混杂因素后，每增加一个单位的METS-IR与高血压风险增加了三倍有关（校正后的OR = 3.48, 95% CI: 2.87, 4.21, P

结论： 利用CHARLS数据，我们发现较高水平的METS-IR独立预测中国老年人群中高血压的发生和流行情况。

关键词： 高血压；发病率；Mets-IR；流行率。