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A new study finds most adults in the U.S. have CKM syndrome. Oliver Rossi/Getty Images
  • A new study finds that 9 out of 10 adults in the U.S. may have cardiovascular-kidney-metabolic (CKM) syndrome.
  • The research found 90% of adults qualify for stage 1 or higher of this condition.
  • CKM syndrome is a systemic disorder that has links between heart disease, kidney disease, diabetes, and obesity.

A new study has revealed that roughly 90% of Americans may have cardiovascular-kidney-metabolic (CKM) syndrome.

The risks are greatest among older adults, men, and Black individuals, the report, which was published in JAMA Wednesday, found.

The American Heart Association (AHA) introduced a new staging system in 2023 — called CKM syndrome — to better treat and manage cardiovascular, kidney, and metabolic diseases, since they are deeply connected and often require a multidisciplinary approach.

CKM syndrome is a systemic disorder that has links between heart disease, kidney disease, diabetes, and obesity.

The new system includes four stages of disease: 0, which indicates a person has no risk factors to 4, which indicates a person has been diagnosed with cardiovascular disease (CVD). In addition to CVD, people with stage 4 may also have kidney failure.

Risk factors can include high blood pressure, high blood sugar, and excess body fat.

Latha Palaniappan, MD, MS, a professor of cardiovascular medicine at Stanford Medicine, says she’s not surprised by the findings, given how prevalent CKM risk factors, including obesity, are. Palaniappan was not involved in the study.

“Despite being a high-income country, the U.S. continues to fall behind in chronic disease mortality and morbidity,” Palaniappan told Healthline.

The chronic conditions that can lead to heart disease

The researchers evaluated health data of 10,762 adults sourced from the National Health and Nutrition Examination Survey.

The participants made up a nationally representative sample of the U.S. population.

The research team evaluated each individual’s CKM stage by looking at their existing risk factors, including hypertension, excess adiposity, chronic kidney disease, or diagnosed CVD like coronary artery disease.

They found that, between 2011 and 2020,

  • 10.6% met criteria for stage 0
  • 26% met criteria for stage 1
  • 49% met criteria for stage 2
  • 5% met criteria for stage 3
  • 9% met criteria for stage 4.

Stage 1 is characterized as a person having excess body fat and higher than normal blood sugar (but not high enough to be considered diabetic).

Stage 2 is characterized as a person having type 2 diabetes, high cholesterol, and high blood pressure.

Stage 3 is characterized as a person having issues with heart and blood vessels but without noticeable symptoms.

Stage 4 is characterized as a person having CKM risk factors and signs of heart disease, such as coronary heart disease, heart failure, stroke, or atrial fibrillation. Stage 4a includes people without kidney failure. Stage 4b includes people with kidney failure.

Adults 65 and older were more likely to have advanced stages (stage 3 and 4) compared to those between the ages of 45 and 64.

About 18% of adults ages 20 to 44 were categorized as stage 0.

Men had a higher risk of advanced-stage CKM syndrome compared to women. Additionally, Black adults were significantly more likely to have advanced-stage CKM syndrome compared to white adults

“These data underscore how prevalent cardiovascular risk factors are in our society,” Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, told Healthline.

Chen was not involved in the study.

“These data provide a framework to help us better characterize the natural disease progression of CKM diseases in the US, to track our progress in better preventing clinical cardiovascular disease,” he added.

How to stop the progression of CKM syndrome

Poor CKM health is common in the U.S., according to the researchers.

The vast majority of the population has risk factors that put them at risk for CKM syndrome: 73% live with overweight or obesity, half of adults have high blood pressure, over 38 million American adults have diabetes, and 1 in 3 adults have prediabetes.

The most common risk factors for CKM syndrome include unhealthy lifestyle behaviors, such as poor nutrition, lack of exercise, and insufficient sleep, says Palaniappan.

As the findings revealed, CKM syndrome disproportionately affects racial minority populations, including Black individuals.

The data “highlight the need to address health inequities to better serve this high-risk population,” says Chen.

Chen says it is essential that CKM risk factors be managed properly so that people do not progress to clinical cardiovascular disease.

Given the high prevalence of CKM syndrome, healthcare professionals should screen for this disease early and often, using people’s body mass index, lifestyle choices, and family history, says Palaniappan.

“Investing in preventive medicine — namely nutrition and exercise — may be the key to lessening the burden of CKM syndrome and CKM syndrome risk factors like obesity, particularly among high-risk populations,” she said.

The bottom line:

A new study has revealed that roughly 90% of Americans may qualify as having stage 1 or higher cardiovascular-kidney-metabolic (CKM) syndrome. Older adults, men, and Black individuals face a heightened risk.