Survey-weighted national proportion (line) and 95% CIs (error bars) are shown (A) overall and by age, (B) race/ethnicity, (C) education level, and (D) income level. Optimal cardiometabolic health was defined as optimal levels for adiposity, blood glucose, blood lipids, blood pressure, and prior CVD (Table 1). Prevalence estimates were adjusted for NHANES survey weights and age-standardized to the 2017–2018 survey cycle age proportions for subgroup analyses. For race/ethnicity, adults identifying as Asian/other were removed from the figure because of large uncertainty in estimates. The findings show declining cardiometabolic health among U.S. adults between 1999 and 2018, with optimal cardiometabolic health generally less common at older vs younger ages, in lower vs higher educated adults, in lower vs higher income adults, and in Mexican American and non-Hispanic Black adults vs adults of other races. AA = Associate of Arts; CVD = cardiovascular disease; NHANES = National Health and Nutrition Examination Survey.