Hypertension, diabetes, and dyslipidemia are common chronic metabolic conditions and major risk factors for cardiovascular disease. These three conditions frequently coexist, presenting a significant public health challenge. Systematically evaluating the epidemiological characteristics and associated factors can be referred for early prevention and control strategies.

To systematically evaluate the prevalence and associated factors of the multimorbidity triad (hypertension, diabetes, and dyslipidemia) among Chinese adults.

CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Web of Science, and The Cochrane Library were systematically retrieved for studies published up to August 2025. Data were analyzed using Stata 18.0 software.

Eighteen cross-sectional studies involving 625,718 participants were included. The meta-analysis indicated that the pooled prevalence of comorbid hypertension, diabetes, and dyslipidemia among Chinese adults was 6.2% (95%CI: 4.9%-7.4%). Significant factors associated with this multimorbidity triad included: family history of diabetes (OR=3.88, 95% CI: 1.57–9.58), obesity (OR=3.71, 95%CI: 2.85–4.81), central obesity (OR=2.47, 95%CI: 1.98–3.07), overweight (OR=2.02, 95%CI: 1.74–2.35), marital disruption (divorced, separated, or widowed) (OR=1.88, 95% CI: 1.55–2.27), male(OR=1.62, 95% CI: 1.35–1.96), smoking (OR=1.54, 95% CI: 1.259–1.884), and alcohol use (OR=1.45, 95% CI: 1.25–1.68) (P<0.05).

The prevalence of comorbid hypertension, diabetes, and dyslipidemia is substantial among Chinese adults. Key associated factors include adiposity (overweight, obesity, central obesity), male, lifestyle behaviors (smoking, alcohol consumption), family history of diabetes, and marital disruption(divorced, separated, widowed). Identifying and managing these modifiable risk factors is critical for clinicians to recognize high-risk individuals and reduce the burden of cardiovascular disease.