Majority of Adults At Risk for CKM Syndrome


Nearly 90% of adults were at risk of developing cardiovascular-kidney-metabolic (CKM) syndrome between 2011 and 2020, according to new research published in JAMA.


  • In 2023, the American Heart Association defined cardiovascular-kidney-metabolic (CKM) syndrome to acknowledge how heart and kidney diseases, diabetes, and obesity interact and are increasingly co-occurring conditions.
  • Researchers used data from the National Health and Nutrition Examination Survey between 2011 and 2020.
  • More than 10,000 adults over age 20 years were included; all of them received a physical and fasting laboratory measurements and self-reported their cardiovascular disease (CVD) status.
  • Researchers created categories for risk, ranging from 0 (no risk factors) to 4, using factors such as kidney disease, obesity, and hypertension.


  • Nearly 90% of participants met the criteria for having a stage of the CKM syndrome, with rates remaining steady throughout the study period.
  • Almost half of people met the criteria for stage 2 (having metabolic risk factors like hypertension or moderate- to high-risk chronic kidney disease).
  • 14.6% met the criteria for advanced stage 3 (very high-risk chronic kidney disease or a high risk for 10-year CVD) and stage 4 CKM syndrome (established CVD) combined.
  • Men, adults over age 65 years, and Black individuals were at a greater risk for advanced stages of the CKM syndrome.


“Equitable health care approaches prioritizing CKM health are urgently needed,” the study authors wrote.


The study was led by Muthiah Vaduganathan, MD, MPH, cardiologist and researcher at Brigham and Women’s Hospital, Harvard Medical School, Boston.


Established CVD statuses were self-reported. Some data that would indicate advanced CKM stages were not available (eg, cardiac biomarkers, echocardiography, and coronary angiography), which may have led to an underestimation of rates.


One author received grants from Bristol Myers Squibb-Pfizer outside the submitted work. Vaduganathan received grants from and was an advisor and committee trial member for various pharmaceutical companies outside the submitted work. The authors reported no other disclosures.

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