Emerging Threat: Cardiovascular-Kidney-Metabolic Syndrome Increasing in the U.S.

Recent research has revealed a troubling increase in the prevalence of cardiovascular-kidney-metabolic (CKM) syndrome across the United States, affecting approximately 80% of the population. This condition, which was first acknowledged by the American Heart Association (AHA) in a 2023 advisory, links heart health, metabolic function, and kidney performance as interrelated factors contributing to cardiovascular disease (CVD).

Prior to the formal classification of CKM syndrome, millions of Americans were unknowingly advancing through its perilous stages. In a groundbreaking analysis led by an assistant professor of epidemiology at the University of Delaware, researchers from multiple institutions, including Houston Methodist Hospital and Harvard Medical School, assessed the state-level prevalence of CKM syndrome using self-reported data from the Centers for Disease Control's Behavioral Risk Factors Surveillance System, spanning the years 2011 to 2023.

The findings, published in the journal JAAC: Advances, indicate that 80% of individuals in the U.S. exhibit some form of CKM syndrome, with no states reporting a decrease in CKM rates over the past decade. West Virginia emerged with the highest prevalence, affecting nearly 87% of its residents, while Delaware's rates increased from 76% to 83%. Colorado had the lowest prevalence at around 72%, with the highest rates concentrated in the Midwest and South regions.

According to the lead researcher, this alarming trend can be attributed to the fragmented healthcare system in the United States. CKM syndrome progresses through several stages, starting from Stage 0 (absence of disease) to Stage 4, which is characterized by severe conditions such as heart failure, stroke, or kidney failure. Stages 1 through 3 involve obesity, prediabetes, hypertension, high cholesterol, and diabetes, all of which significantly elevate the risk of developing CVD.

Analysis revealed that nearly half of the states experienced an increase in CKM prevalence for stages 1 to 3, while Stage 4 saw a decline nationally, except in Minnesota, which reported a significant rise in this critical stage.

To mitigate the progression of CKM syndrome and reduce the incidence of CVD, regular health screenings are essential. However, efforts to encourage healthcare providers to evaluate these interconnected conditions holistically are still in their infancy. Public education is crucial to raise awareness that CKM syndrome encompasses more than just managing obesity, diabetes, or cardiovascular issues in isolation. Lifestyle and behavioral modifications are necessary to prevent a single risk factor from escalating into multiple health complications.

Moreover, variations in state-level health programs complicate the issue, as some initiatives focus solely on diabetes management instead of addressing other related risk factors for CVD. It is imperative that these programs be expanded to encompass a broader range of health concerns associated with CKM syndrome.

The AHA has recently initiated a pilot program aimed at improving health outcomes in specific cities, including Atlanta, San Diego, Baton Rouge, Washington, D.C., Maryland, Ohio, and parts of Kentucky. This initiative seeks to bring together healthcare providers from various specialties to adopt a comprehensive approach to managing CKM syndrome.

Looking ahead, researchers plan to analyze clinical data from electronic health records to gain a deeper understanding of CKM syndrome and develop predictive models to slow its progression.