Pooled prevalence of cardiovascular disease and major cardiometabolic risk factors in selected asian adults: a systematic review and meta-analysis

Abstract Background Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in Asia, where rapid demographic and lifestyle changes have increased the burden of cardiometabolic risk factors. However, comprehensive pooled estimates of both cardiovascular diseases and major modifiable risk factors across Asian populations remain limited. This systematic review and meta-analysis aimed to quantify their prevalence and examine regional variation. Methods We conducted a systematic search of PubMed/MEDLINE and Scopus for population-based observational studies published between 1 January 2015 and 16 February 2026. Eligible studies reported prevalence of overall CVD, stroke, Coronary heart disease (CHD), hypertension, diabetes, obesity, or smoking among adults (≥ 18 years). Random-effects meta-analyses using logit-transformed proportions were performed to estimate pooled prevalence with 95% confidence intervals (CIs). Between-study heterogeneity was assessed with the I² statistic, and subgroup and meta-regression analyses explored regional and temporal variation. Results Sixty two studies involving 2,379,293 adults from 11 Asian countries were included. The pooled prevalence was 5.53% (95% CI: 2.15–13.47) for overall CVD, 1.83% (95% CI: 1.04–3.20) for stroke, and 3.0% (95% CI: 1.0–6.0) for CHD. The pooled prevalence of major modifiable cardiovascular risk factors was 29.0% (95% CI: 22.5%–36.5%) for hypertension, 11.0% (95% CI: 8.5–14.1) for diabetes, 37.6% (95% CI: 28.4–47.9) for obesity, and 22.0% (95% CI: 11.0–39.0) for smoking. Regional subgroup analyses were conducted for hypertension, diabetes, and obesity where sufficient studies were available. Substantial between-study heterogeneity persisted across outcomes (I² > 99%). Conclusions The convergent burden of CVD and cardiometabolic risk factors across the included Asian populations underscores a critical stage of cardiovascular transition. However, given the substantial between-study heterogeneity, pooled continental estimates should be interpreted with caution. Regional subgroup analyses were conducted for selected risk factors, including hypertension, diabetes, and obesity, where sufficient studies were available, but these findings should not be generalized to all outcomes. Strengthened hypertension and metabolic risk management, along with tailored preventive strategies, are essential to curb future cardiovascular morbidity in the region.