BACKGROUND: Insulin resistance (IR) reduces insulin efficacy and heightens the danger of cardiovascular diseases including hypertension. The Metabolic Score for Insulin Resistance (METS-IR), which is based on triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), body mass index (BMI), and fasting glucose levels, provides a simpler way to assess IR. As the hypertension's prevalence increases, particularly in those with metabolic disorders, exploring the relationship between hypertension and METS-IR has become crucial. METHODS: 16,310 individuals from the 2007-2018 National Health and Nutrition Examination Survey dataset was included. Hypertension was defined by asking participants about their medical history and blood pressure measurements. METS-IR was calculated as follows: ln([ HDL-C (mg/dL)] × [2 × fasting glucose (mg/dL)] + TG (mg/dL) × BMI (kg/m RESULTS: This research demonstrated a significant positive relationship between hypertension and METS-IR. Each 1-unit rise in METS-IR corresponds to a 3% higher chance of hypertension (odds ratio [OR], 1.03
95% confidence interval [CI], 1.03-1.04). In model 3, METS-IR exhibited a notable correlation with hypertension (OR, 3.31
95% CI, 2.64-4.14
P <
0.001). A threshold effect analysis demonstrated a nonlinear association. Finally, subgroup analyses supported the stability of the relationship between METS-IR and factors such as sex, race, alcohol consumption, CHD, smoking, and stroke (P >
0.05). CONCLUSIONS: METS-IR showed a strong relationship with hypertension and may be an important marker for evaluating metabolic health and the early hypertension danger.