October 09, 2023
Source/Licensed from Ingram Image
Cardiovascular-kidney-metabolic syndrome, or CKM, reflects the links among heart disease, obesity, type 2 diabetes and kidney disease. The American Heart Association has provided guidance for health care providers on how to screen for the syndrome.
One in three adults in the United States have three or more risk factors that can contribute to heart disease, metabolic disorders or kidney disease. On Monday, the American Heart Association defined a new condition, cardiovascular-kidney-metabolic syndrome, in an effort to show how these diseases interact with each other.
CKM syndrome reflects the strong links between cardiovascular disease, kidney disease, type 2 diabetes and obesity, according to an advisory published in the journal Circulation. By recognizing the new condition, health experts hope to diagnose and treat chronic illnesses earlier in order to prevent more serious illnesses, including heart disease, from developing.
People who have or who are at risk for heart disease may also have CKM syndrome. While the condition affects nearly every organ in the body, its biggest impact is on the cardiovascular system, affecting blood vessels and heart muscle function, the rate of fatty buildup in the arteries and electrical impulses in the heart.
The U.S. Centers for Disease Control and Prevention estimates that 41.9% of adults and 19.7% of children in the U.S. are obese, and that more than 37 million adults have diabetes. The CDC also says 15% of U.S. adults have chronic kidney disease. The most common cause of death for people with obesity, diabetes or kidney disease is heart disease.
"The advisory addresses the connections among these conditions with a particular focus on identifying people at early stages of CKM syndrome," said Dr. Chiadi E. Ndumele, associate professor of medicine and director of obesity and cardiometabolic research at Johns Hopkins University. "Screening for kidney and metabolic disease will help us start protective therapies earlier to most effectively prevent heart disease and best manage existing heart disease."
The screening process for CKM syndrome, which takes place over five stages, is designed to detect heart, kidney and metabolic health risks early, identify barriers to health care and prevent progression to later stages. While the advisory addresses care for adults, studies have shown that CKM syndrome can begin earlier in life.
According to the advisory, treatment for CKM syndrome would begin in stage zero, when there are no risk factors present. The goal would be to prevent the condition entirely by maintaining a healthy heart through healthy eating, physical activity, sleep, avoiding nicotine and maintaining healthy weight, blood pressure, blood sugar and cholesterol.
Progression into stage one means excess body fat or prediabetes symptoms. The goal at a stage one diagnosis would be implement lifestyle changes, like exercising and healthy eating. If those symptoms progress into stage two, doctors could prescribe medication addressing blood sugar, blood pressure and cholesterol.
If CKM syndrome progresses into stage three, patients are diagnosed with asymptomatic heart disease. The goal would be to prevent the disease from progressing through lifestyle changes, new medications and intensified therapies. If the condition progresses into stage four, patients are diagnosed with symptomatic cardiovascular disease and would likely receive individualized treatment with consideration of other concurrent illnesses, according to the advisory.
"There is a need for fundamental changes in how we educate health care professionals and the public, how we organize care and how we reimburse care related to CKM syndrome," Ndumele said. "Key partnerships among stakeholders are needed to improve access to therapies, to support new care models and to make it easier for people from diverse communities and circumstances to live healthier lifestyles and to achieve ideal cardiovascular health."
By looking at CKM syndrome as a "bigger target," doctors could identify and treat patients before obesity, kidney problems and diabetes progress into more serious illnesses, Dr. Howard Weintraub, clinical director for the Center for Prevention of Cardiovascular Disease at NYU Langone Health, told NBC News.
Getting people to associate obesity with more serious health outcomes and seek treatment prior to turning 30 may also be beneficial, Weintraub said. Obesity rates and lifestyle factors have also been linked to a rise in cancer rates among people in their 30s, according to a study published earlier this year.
The advisory explains that more research is needed to better understand how these conditions progress into heart disease, why disease in some people progresses faster than disease in others and the best ways to implement treatments that collectively affect type 2 diabetes, heart disease and kidney disease.
