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. 2025 May 14;4(6):101785. doi: 10.1016/j.jacadv.2025.101785

Table 2.

Change in Prevalence and Treatment of Metabolic Syndrome and Its Components by Race and Ethnicity, Comparing 1999–2002 vs 2015–2018

Black Individuals
Percentage Points (95% CI)
P Value Hispanic Individuals
Percentage Points (95% CI)
P Value White Individuals
Percentage Points (95% CI)
P Value Total
Percentage Points (95% CI)
P Value
Overall prevalence of metabolic syndrome
 Change in prevalence, 1999–2018 +9.53 (5.27-13.79) <0.001 +10.93 (5.37-16.49) <0.001 +11.74 (7.90-15.59) <0.001 +11.07 (8.05-14.09) <0.001
 Difference with White, 1999–2002 −8.44 (−12.07 to −4.81) <0.001 −4.00 (−9.63 to 1.63) 0.157 - - - -
 Difference with White, 2015–2018 −10.32 (−14.86 to −5.79) <0.001 −3.91 (−8.35 to 0.53) 0.082 - - - -
 Change in difference with White, 1999–2018 −2.08 (−7.61 to 3.44) 0.453 −0.86 (−7.81 to 6.09) 0.805 - - - -
Prevalence of elevated blood pressure
 Change in prevalence, 1999–2018 +6.03 (−0.68 to 12.73) 0.077 +6.69 (−0.02 to 13.39) 0.051 −0.32 (−4.23 to 3.60) 0.872 +0.94 (−2.54 to 4.42) 0.592
 Difference with White, 1999–2002 +4.54 (0.94-8.15) 0.015 −15.30 (−21.03 to −9.56) <0.001 - - - -
 Difference with White, 2015–2018 +11.63 (6.14-17.12) <0.001 −7.10 (−12.53 to −1.68) 0.012 - - - -
 Change in difference with White, 1999–2018 +6.63 (0.35-12.91) 0.039 +7.09 (−0.66 to 14.85) 0.072 - - - -
Prevalence of elevated fasting glucose
 Change in prevalence, 1999–2018 +20.43 (14.50-26.35) <0.001 +26.78 (21.19-32.38) <0.001 +27.44 (23.26-31.61) <0.001 +26.39 (22.70-30.08) <0.001
 Difference with White, 1999–2002 −7.16 (−12.69 to −1.63) 0.013 +3.96 (−1.12 to 9.05) 0.122 - - - -
 Difference with White, 2015–2018 −13.80 (−18.14 to −9.46) <0.001 +4.26 (−0.05 to 8.56) 0.052 - - - -
 Change in difference with White, 1999–2018 −6.97 (−13.74 to −0.19) 0.044 −0.69 (−7.01 to 5.63) 0.828 - - - -
Prevalence of elevated triglyceride
 Change in prevalence, 1999–2018 +5.92 (1.69-10.15) 0.007 −1.06 (−7.17 to 5.04) 0.727 +0.10 (−4.32 to 4.52) 0.963 +0.27 (−3.16 to 3.70) 0.875
 Difference with White, 1999–2002 −20.26 (−24.97 to −15.55) <0.001 −2.73 (−8.73 to 3.26) 0.358 - - - -
 Difference with White, 2015–2018 −13.81 (−17.76 to −9.86) <0.001 −3.06 (−7.34 to 1.22) 0.155 - - - -
 Change in difference with White, 1999–2018 +5.84 (−0.21 to 11.88) 0.058 −1.37 (−8.56 to 5.81) 0.703 - - - -
Prevalence of elevated waist circumference
 Change in prevalence, 1999–2018 +9.16 (3.51-14.81) 0.002 +19.22 (13.34-25.11) <0.001 +15.27 (9.90-20.64) <0.001 +14.88 (10.58-19.19) <0.001
 Difference with White, 1999–2002 +3.35 (−2.61 to 9.31) 0.259 −2.06 (−7.29 to 3.16) 0.425 - - - -
 Difference with White, 2015–2018 −2.32 (−7.72 to 3.08) 0.386 +2.44 (−3.71 to 8.59) 0.423 - - - -
 Change in difference with White, 1999–2018 −6.18 (−13.91 to 1.55) 0.115 +3.94 (−4.01 to 11.88) 0.325 - - - -
Prevalence of reduced HDL-C
 Change in prevalence, 1999–2018 +0.84 (−4.72 to 6.40) 0.762 −0.71 (−6.70 to 5.27) 0.811 +1.86 (−2.77 to 6.49) 0.425 +1.34 (−2.25 to 4.93) 0.459
 Difference with White, 1999–2002 −6.98 (−12.78 to −1.19) 0.02 +1.19 (−3.90 to 6.29) 0.635 - - - -
 Difference with White, 2015–2018 −7.54 (−13.02 to −2.06) 0.009 −0.97 (−6.48 to 4.55) 0.722 - - - -
 Change in difference with White, 1999–2018 −0.97 (−8.67 to 6.74) 0.803 −2.75 (−10.06 to 4.55) 0.453 - - - -
Use of antihypertensive medications
 Change in prevalence, 1999–2018 +3.02 (−9.08 to 15.11) 0.616 +18.16 (5.35-30.96) 0.007 +15.11 (6.08-24.13) 0.001 +13.32 (6.69-19.94) <0.001
 Difference with White, 1999–2002 +13.36 (2.93-23.79) 0.001 −25.48 (−34.97 to −16.00) <0.001 - - - -
 Difference with White, 2015–2018 +1.24 (−11.30 to 13.79) 0.841 −23.19 (−38.90 to −7.48) 0.005 - - - -
 Change in difference with White, 1999–2018 −12.09 (−28.21 to 4.03) 0.138 +3.05 (−14.61 to 20.71) 0.731 - - - -
Use of antihyperglycemic medications
 Change in prevalence, 1999–2018 +4.42 (−8.13 to 16.98) 0.479 +8.25 (−1.79 to 18.28) 0.104 +6.27 (−0.09 to 12.64) 0.053 +6.27 (1.16-11.39) 0.017
 Difference with White, 1999–2002 +13.79 (1.46-26.11) 0.030 +2.29 (−4.62 to 9.21) 0.502 - - - -
 Difference with White, 2015–2018 +12.07 (4.66-19.47) 0.002 +3.89 (−6.57 to 14.35) 0.452 - - - -
 Change in difference with White, 1999–2018 −1.85 (−16.07 to 12.37) 0.795 +1.98 (−10.19 to 14.14) 0.746 - - - -
Use of lipid-lowering medications
 Change in prevalence, 1999–2018 +30.49 (22.18-38.79) <0.001 +20.83 (11.45-30.21) <0.001 +23.78 (15.22-32.34) <0.001 +23.25 (16.75-29.75) <0.001
 Difference with White, 1999–2002 −7.86 (−17.49 to 1.77) 0.106 −18.36 (−25.59 to −11.13) <0.001 - - - -
 Difference with White, 2015–2018 −0.56 (−8.22 to 7.09) 0.882 −20.74 (−29.96 to −11.52) <0.001 - - - -
 Change in difference with White, 1999–2018 +6.71 (−5.42 to 18.83) 0.272 −2.95 (−14.52 to 8.62) 0.611 - - - -

P values for comparisons between 1999–2002 and 2015–2018 were calculated using weighted two-sample t-tests for proportions. Trend P values were derived from weighted linear regression analyses, incorporating NHANES survey design and weights to assess changes from 1999 to 2018.

HDL-C = high-density lipoprotein cholesterol.