JAMA research shows nearly four in ten American adults live with clustered heart risk factors, with older adults most affected
Washington, D.C., United States, 15 December 2025 – Metabolic syndrome continues to affect a large share of the adult population in the United States, according to a new study published in The Journal of the American Medical Association (JAMA). Researchers found that nearly 40 percent of U.S. adults met the criteria for the condition in 2023, underscoring a persistent public health challenge despite years of awareness and prevention efforts.
Metabolic syndrome is not a single disease but a combination of risk factors that increase the likelihood of heart disease, stroke, and type 2 diabetes. These include high blood pressure, high blood sugar, unhealthy cholesterol levels, excess abdominal fat, and elevated triglycerides. When three or more of these factors are present, a person is considered to have metabolic syndrome.
Tracking a decade of health data
The study analyzed data from the National Health and Nutrition Examination Survey, focusing on adults aged 20 and older between 2013 and August 2023. Researchers used age-adjusted estimates based on U.S. Census data to assess trends over time and across different population groups.
Overall, the prevalence of metabolic syndrome rose slightly from 35.4 percent in 2013–14 to 38.5 percent in 2021–23. However, this increase was not statistically significant, suggesting that rates have largely remained stable over the past decade.
One component did stand out. Elevated triglyceride levels, a type of blood fat linked to cardiovascular disease, showed a clear upward trend after initially declining earlier in the study period. By 2021–23, about one in four adults had high triglyceride levels.
Who is most affected?
Age emerged as a key factor. Adults aged 60 and older showed a significant rise in metabolic syndrome prevalence, increasing from just over 50 percent to more than 62 percent during the study period. In contrast, rates among younger adults remained relatively steady.
The study found no meaningful differences between men and women overall. However, a notable increase was observed among non-Hispanic Black adults, highlighting potential disparities related to long-term stress, access to healthcare, and social determinants of health.
Pandemic effects and health concerns
Researchers noted that disruptions caused by the COVID-19 pandemic may have played a role in some of the observed trends. Changes in diet, physical activity, medication adherence, and access to routine medical care could have contributed to worsening cholesterol profiles and metabolic health in certain groups.
While the study did not find dramatic overall changes, the fact that nearly four in ten adults still meet the criteria for metabolic syndrome raises concerns about future cardiovascular disease burden. Because the data are cross-sectional, the study cannot establish cause-and-effect relationships, but it provides a clear snapshot of ongoing risk.
Public health implications
Experts emphasize that metabolic syndrome is largely preventable and manageable through lifestyle changes such as healthier eating, regular physical activity, weight management, and consistent medical care. The findings suggest that targeted prevention efforts are especially important for older adults and communities facing higher health risks.
As healthcare systems continue to recover from pandemic-related disruptions, the study highlights the need for sustained focus on preventive care, chronic disease management, and equitable access to health services.