HypertensionCross-sectional study
Trends in Prevalence, Treatment, and Control of Cardiometabolic Risk Factors Among Adults With Hypertension in the United States, 1999-2023
- Serial cross-sectional study
- NHANES
- age-adjusted
Authors' conclusion
The burden of cardiometabolic risk factors among U.S. adults with hypertension has increased overall, with concurrent diabetes and hyperlipidemia now affecting more than 1 in 5. Only one-quarter of adults with hypertension, diabetes, and hyperlipidemia have all 3 conditions controlled-a proportion that has not improved in more than a decade.
Study context
- Population
- US adults with hypertension, NHANES 1999–2023
- Participants
- 21,822 adults
- Outcome
- Trends in age-adjusted prevalence of diabetes, hyperlipidemia, obesity, smoking and high-risk drinking, and in age-adjusted treatment and control rates for hypertension, diabetes and hyperlipidemia
- Follow-up
- 1999 to 2023
Main finding
As reported in the abstract
- Diabetes prevalence, 1999-2000
- 17.2% (95% CI: 14.6%-20.2%)
- Diabetes prevalence, 2021-2023
- 27.8% (95% CI: 25.2%-30.7%)
- Hypertension + diabetes: treated for both, 2021-2023
- 71.6% (rose until 2009-2010, then plateaued; 95% CI: 67.5%-75.4%)
- Hypertension + diabetes: both controlled, 2021-2023
- 31.2% (95% CI: 26.5%-36.3%)
- Hyperlipidemia prevalence (decreased), 2021-2023
- 73.1% (95% CI: 70.6%-75.4%)
- Hypertension + hyperlipidemia: treated for both, 2021-2023
- 50.4% (increased only until around 2007; 95% CI: 47.2%-53.6%)
- Hypertension + hyperlipidemia: both controlled, 2021-2023
- 32.3% (95% CI: 29.5%-35.2%)
- Concurrent diabetes and hyperlipidemia, 1999-2000
- 12.5% (95% CI: 10.6%-14.7%)
- Concurrent diabetes and hyperlipidemia, 2021-2023
- 21.3% (nearly doubled; 95% CI: 19.0%-23.8%)
- All 3 conditions treated, 2021-2023
- 62.1% (increased until 2007-2008, then plateaued; 95% CI: 56.6%-67.2%)
- All 3 conditions controlled, 2021-2023
- 26.3% (95% CI: 20.8%-32.6%)
Observational data: associations, not effects.
Original publication
Trends in Prevalence, Treatment, and Control of Cardiometabolic Risk Factors Among Adults With Hypertension in the United States, 1999-2023. J Am Coll Cardiol. Published 26 November 2025. doi:10.1016/j.jacc.2025.09.1607
Summarised from the published abstract; every number is checked against it