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Introduction:Nationally representative data evaluating recent trends in racial and ethnic differences in prevalence and treatment of metabolic syndrome (MetS) are sparse.Methods:We evaluated 21-year trends in the prevalence and treatment of MetS and individual components in 21,602 adults, using data from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2020. We used weighted linear regression to estimate time trends and compared these trends by race and ethnicity.Results:Among participants, the mean age was 47.7 (SD, 2.2) years; 51 % were female; 78 %, 12.7%, and 9.3% were White, Black, and Hispanic. From 1999 to 2020, the prevalence of MetS as well as the prevalences of elevated waist circumference and elevated fasting glucose increased significantly for Black, Hispanic, and White individuals (P<0.01 for all). The prevalences of elevated blood pressure and elevated triglyceride increased among Black individuals but did not change among Hispanic and White individuals. The use of antihypertensive, antihyperglycemic, and lipid-modifying medications also increased for all racial/ethnic subgroups. Racial/ethnic disparities in prevalence and treatment of MetS and individual components persisted throughout the study period. Compared with White individuals, Black individuals had higher use of antihypertensive medications but lower use of lipid-modifying medications (P<0.01 for all). Hispanic individuals had lower use of antihypertensive medications and lipid-modifying medications (P<0.01 for all). Across all racial/ethnic subgroups, less than 60% and 30% of people with medication indications received lipid-modifying and antihyperglycemic medications, respectively.Conclusions:Temporal trends suggest an increase in prevalence of MetS. There were persistent racial/ethnic disparities in use of antihypertensive, antihyperglycemic, and lipid-modifying medications among people with medication indications.

Introduction:Reducing overall rates of and the racial/ethnic differences in obesity is a public health priority in the US. However, it is unknown how the racial/ethnic differences in different adiposity measures changed in the US population over recent decadesMethods:Using data from the National Health and Nutrition Examination Survey 1999-2018, we determined trends in the racial/ethnic differences of several adiposity measures and whether race/ethnicity moderates the associations between these measures and all-cause mortality. Adiposity measures included overweight (body mass index [BMI] of 25.0-29.9 kg/m2), overall obesity (BMI ≥30.0 kg/m2), abdominal obesity (waist circumference [WC] ≥88 cm for women or ≥102 cm for men), and high body fat (body fat mass percentage [FM] ≥35% for women or ≥25% for men).Results:The study included 49,629 adults aged 18-79 years (mean age 45.3 [SD, 17.9] years, 51.3% women), of whom 12.5% were Black, 15.5% were Latino/Hispanic, and 72.0% were White. Between 1999 and 2018, Latino/Hispanic people had a higher prevalence of overweight, overall obesity, abdominal obesity, and high body fat than White people. The gaps between Latino/Hispanic and White people significantly increased for all adiposity measures (P<0.01 for all measures) during this time. Black people had a higher prevalence of overweight, overall obesity, and abdominal obesity, but a similar prevalence of high body fat compared with White people. There were no significant changes in the gaps between Black and White people for any adiposity measures. For all adiposity measures, the associations between adiposity measures and mortality did not differ by race/ethnicity.Conclusions:Racial/ethnic differences in the prevalence of overweight, overall obesity, abdominal obesity, and high body fat persisted or increased over 20 years, with the differences increasing between Latinos/Hispanics and Whites and not changing between Blacks and Whites.

Introduction:Black and Hispanic adults have poorer hypertension control compared with White adults in the US. Less is known about the country’s progress in eliminating disparities in awareness and treatment of hypertension and whether these differences explain the difference in hypertension control.Methods:We assessed 20-year trends in racial/ethnic differences in awareness, use of medication, and whether these differences help explain racial/ethnic difference in blood pressure (BP) control in the US population, using data from 59,204 hypertensive adults enrolled in the National Health and Nutrition Examination Survey (1999-2018).Results:For all 3 racial groups (White, Black, and Hispanic), hypertension awareness, treatment, and control rates increased between 1999-2013, and then declined between 2014-2018. Although Black adults had a lower BP control rate (odds ratio: 0.77 [0.70-0.85]) compared with White adults, they had a higher awareness rate (1.30 [1.13-1.46]), a similar overall treatment rate (1.07 [0.94-1.19]) and received more intensive antihypertensive therapy (OR for combination therapy 1.32 [1.19-1.45]). Hispanic adults had a significantly lower BP control rate (0.68 [0.59-0.77]), awareness rate (0.76 [0.65-0.85]), overall treatment rate (0.65 [0.55-0.74]) and received less intensive therapy compared with Black and White adults. From 1999-2018, the racial/ethnic differences in awareness, treatment, and BP control persisted and were more pronounced among younger (<60 years of age), male, and lower income adults. Lower awareness and treatment were associated with lower BP control in Hispanics, but not in Blacks.Conclusions:Although Blacks had higher level of awareness and received more intensive antihypertensive therapy, Hispanics were less aware and treated than White. Racial/ethnic differences in awareness and treatment partially explain difference in hypertension control for Hispanics, but not for Blacks.