Trends in Prevalence, Treatment, and Relationship of Metabolic Syndrome and Individual Components by Race/Ethnicity, 1999-2018

Background: Nationally representative data on recent trends in racial/ethnic differences in metabolic syndrome (MetS) prevalence and treatment are sparse. Objectives: The purpose of this study was to examine 20-year trends in the prevalence, treatment, and interrelationships of MetS and its individu...

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Main Authors: Yuan Lu, ScD, Xumin Li, MS, Yuntian Liu, MPH, César Caraballo, MD, Daisy Massey, BA, Shiwani Mahajan, MD, MHS, Erica Spatz, MD, MHS, Jeph Herrin, PhD, Harlan M. Krumholz, MD, SM
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X25002030
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Summary:Background: Nationally representative data on recent trends in racial/ethnic differences in metabolic syndrome (MetS) prevalence and treatment are sparse. Objectives: The purpose of this study was to examine 20-year trends in the prevalence, treatment, and interrelationships of MetS and its individual components among U.S. adults, overall and by race/ethnicity. Methods: We evaluated trends from 1999 to 2018 in 20,397 adults using data from the National Health and Nutrition Examination Survey. Age-standardized prevalence estimates were calculated for MetS, its components, and related prescription drug use. Trends were assessed using weighted linear regression, and racial/ethnic disparities were examined using t-tests. Results: The mean age was 47.5 (47.4-47.6) years; 51.3% were female; 77.9%, 12.8%, and 9.4% were White, Black, and Hispanic, respectively. MetS prevalence increased significantly from 1999 to 2018 across all groups (P < 0.001). Among MetS components, waist circumference and fasting glucose increased across all groups, while triglycerides increased only among Black individuals. Lipid-lowering medication use increased (P < 0.001), but racial/ethnic disparities persisted. Compared to White individuals, Hispanic individuals had lower antihypertensive and lipid-lowering medication use (P < 0.01). Despite increased prescriptions, <65% of eligible individuals received lipid-lowering therapy, and <35% received antihyperglycemic therapy, highlighting substantial treatment gaps. Racial/ethnic differences in MetS component relationships were observed: blood pressure played a larger role in Black individuals, while fasting glucose was more prominent in Hispanic individuals. Conclusions: MetS prevalence has increased over 2 decades. Persistent racial/ethnic disparities exist in antihypertensive, antihyperglycemic, and lipid-lowering medication use. Across all racial/ethnic subgroups, large opportunities remain for improving treatment strategies among individuals with medication indications.
ISSN:2772-963X