Hypertension plays a central role in defining metabolic syndrome, yet the association between metabolic syndrome and its components with prehypertension and stage one hypertension remains unclear. This study aims to assess and compare the prevalence of metabolic syndrome in patients with raised blood pressure (prehypertension) and those with stage one hypertension.

This cross-sectional study utilizes data from the Kerman Coronary Artery Disease Risk Factors (KERCADRS) project, a comprehensive initiative investigating coronary artery risk factors in Kerman province, southeastern Iran. Metabolic syndrome is defined according to the US National Cholesterol Education Program Adult Treatment Panel III criteria, while blood pressure categorization follows the American College of Cardiology/American Heart Association criteria.

Among 9993 individuals assessed, 2328 matched the metabolic syndrome criteria, yielding an overall prevalence of 23.3%. Raised blood pressure (17.6%) and stage one hypertension (30.1%) were observed. The group with stage one hypertension exhibited higher rates of metabolic syndrome (29.9% vs. 21.2%, p = 0.001) and elevated serum triglycerides (37.6% vs. 29.3%, p = 0.001) compared to those with raised blood pressure. The prevalence of metabolic syndrome was higher in stage one hypertension patients than in those without this condition, particularly within the 20 to 60 age range.

Metabolic syndrome is associated with stage one hypertension rather than raised blood pressure, with this association more pronounced in middle-aged individuals.