Objectives:
Recent trends towards socioeconomic and demographic transition have led to simultaneous increase in multiple cardiometabolic (CM) risk markers such as overweight/obesity, diabetes mellitus (DM) and hypertension (HTN) worldwide. This study assesses the multiple CM risk factors and their association with socioeconomic status among semi-urban population of Nepal.

Methods:
A cross-sectional survey was conducted, including 2,310 adults aged 25–64 years from a semi-urban Pokhara-Lekhnath area using World Health Organization-STEPS questionnaire. Respondents were categorized as singly morbid (DM; HTN; Overweight/obese), doubly morbid (DM and HTN; Overweight/ Obese and HTN; Overweight/ Obese and HTN; Overweight/ Obese and DM), and triply morbid (Overweight/ Obese and DM and HTN).

Results:
The mean age of the respondents was 47.37 ± 9.9 years, with 68% being females. In total 65% were hypertensive with ≥130/80 mmHg, 11.7% had diabetes with ≥7.0 mmol/l fasting glucose and 62.6% were overweight/obese. Only 16.2% of participants did not have any CM risk factors while 36.9% were singly morbid. Remaining 46.9% respondents had clustering of risk factors (≥two risk factors). Of them, 39.3% and 7.6% participants were doubly and triply morbid, respectively. Increasing age and indigenous ethnicity were significantly associated across singly, doubly and triply morbid conditions (p < 0.01).

Conclusion:
Our study found a high prevalence and clustering of multiple CM risk factors at individual level, highlighting the maturation of CM syndemics from single to multiple CM risk factors in Nepal. This serves as a wake-up call for action for planning of health services for prevention and management of multiple CM risk factors together.