Diabetes, high blood pressure, and obesity are included in a cluster of risk factors experts refer to as metabolic syndrome — and new research shows adults with metabolic syndrome are more likely to die from heart disease.

The study, published in The Journal of Clinical Endocrinology & Metabolism ahead of print, examined the health records of 155,971 participating in a health screening program at Kangbuk Samsung Hospital in Korea between 2002 and 2009. Participants answered questions, were weighed, as well as measured for body mass index, blood pressure, cholesterol, and blood sugar. In order to measure mortality, researchers referenced death records collected by Korea’s National Statistical Office.

The results showed the 12.6 percent of participants with metabolic syndrome at baseline were nearly twice as likely to die from cardiovascular disease in comparison to participants without metabolic syndrome; 542 subjects had died when researchers followed up with program participants three years later. The risk of death was even greater for women with metabolic syndrome.

But interestingly, when researchers factored out participants with diabetes or high blood pressure, this wasn’t the case.

"The analysis tells us diabetes and high blood pressure are significant factors that elevate the risk of death from cardiovascular disease among people with metabolic syndrome," Dr. Eun-Jung, study co-author, said in a press release. "Younger people who have metabolic syndrome should be aware of the risk, particularly those who have diabetes and high blood pressure."

The Endrocrine Society estimates 22.9 percent of adults in the U.S. have metabolic syndrome. The Society adds the average medical cost for someone with metabolic syndrome is a little over $40,000 versus the average $33,000 individuals without diabetes, high blood pressure, or additional risk factors have to pay.

However, metabolic syndrome doesn’t only worsen cardiovascular disease. One study found a “borderline significant relationship between metabolic syndrome and glaucoma,” while another study suggested there may be a relationship between metabolic syndrome and breast cancer.

There are a wide range of treatments available to help individuals control their risk factors, from surgery to lifestyle intervention; an individual’s treatment will vary depending on their personal needs. Generally, modifying eating habits, physical, and sedentary activity are recommended to mitigate these risk factors for disease.

Source: Sung K-C, K, Rhee E-J, et al. Increased Cardiovascular Mortality in Subjects With Metabolic Syndrome Is Largely Attributable to Diabetes and Hypertension in 159 971 Korean Adults. The Journal of Clinical Endocrinology & Metabolism. 2015.