Abstract: Objective To investigate the interaction between the stress hyperglycemia ratio (SHR) and hypertension among a community population in Chun'an County, and to inform the development of targeted comprehensive community intervention strategies based on the findings. Methods Between January and February 2024, a stratified random sampling method was employed to select 1 022 permanent residents from the health records of community health service centers in Chun'an County as study participants. Sociodemographic data were collected via a questionnaire, and levels of SHR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded. Participants were stratified based on the presence or absence of hypertension to compare SHR levels and other baseline characteristics. A logistic regression model was constructed using key variables to analyze the association between SHR levels and the risk of hypertension. Furthermore, participants were categorized into quartiles based on their SHR levels to compare differences in blood pressure (SBP and DBP) across these groups. Spearman correlation analysis was utilized to assess the correlation between SHR and both SBP and DBP. Results Among the 1 022 participants, 340 were diagnosed with hypertension, corresponding to a prevalence rate of 33.27% (340/1 022). The prevalence was higher in males at 35.23% (210/596) compared to females at 30.52% (130/426). The blood pressure control rate (blood pressure maintained below the target value) among residents aged 18 years and older was 39.12% (133/340). Unadjusted logistic regression analysis revealed a significant association between SHR levels and the risk of hypertension (OR=8.958, 95% CI: 5.178-15.498). This association remained significant after adjusting for confounding factors, including age, BMI, history of alcohol consumption, history of smoking, frequency of physical exercise, and average daily sleep duration (OR=9.616, 95% CI: 5.115-18.080). Statistically significant differences in both SBP and DBP levels were observed across the SHR quartiles (all P<0.01). Spearman correlation analysis demonstrated a significant positive correlation between SHR and both SBP (r=0.587, P<0.05) and DBP (r=0.580, P<0.05). Conclusions SHR is an independent risk factor for hypertension in this community-dwelling population. A significant positive correlation and a synergistic mechanism exist between SHR and hypertension. The development of community-based comprehensive intervention strategies predicated on SHR levels may facilitate the early prevention and control of hypertension.

Key words: Stress hyperglycemia ratio, Hypertension, Risk of prevalence, Systolic blood pressure, Diastolic blood pressure