OBJECTIVES: Modifiable risk factors such as trio Hs are major contributor to the disease burden in Malaysia. Heart disease is number one leading cause of death in the country and individuals with diabetes are two to four times more likely to develop heart disease or stroke relative to those without diabetes. In view of severe multifold outcome caused by trio Hs, we aim to examine the prevalence of undiagnosed trio Hs and management of these risk factors among participants who had previously detected with these conditions. METHODS: We retrospectively performed secondary data analysis on random selective samples from Pfizer Care-a-Van community health screening which was established in year 1999. Health screenings were conducted in mobile examination centers across the country by a team of registered physician, nurses, and volunteers along with various NGO partners. Standardized screening forms were used to collect demographic data and screening results. Participants with abnormal screening results will be referred to government clinics or hospitals for further tests and/or treatment. Descriptive analysis was performed using Stata 13. RESULTS: A total of 7601 subjects were available for analysis from 2003 till 2014. Over half (58.4%) of the screening participants were female aged 45.8 years (SD, 14.4). 13.3% had been previously diagnosed with hyperlipidemia, while 10.6% and 13.1% were diabetic and hypertensive. Undiagnosed hyperlipidemia was reported at 56.5%, followed by hyperglycemia (32.5%) and hypertension (17.8%). Almost half (49.9%) of hypertensive and 59.2% hyperlipidemia subjects failed to achieve target blood pressure and cholesterol level whereas only 38.2% diabetic had their blood glucose under control. CONCLUSIONS: Multiple risk factors pose a significant burden in Malaysia. Undiagnosed and failure to achieve trio Hs treatment goals further increased complication and severity of the chronic conditions. Hyperlipidemia was highly underdiagnosed and efforts are needed to manage these conditions in holistic manner rather than isolation.