10 Oct 2023 • The American Heart Association (AHA) has introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which encompasses health disorders arising from the overlap of obesity, diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD), including heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral artery disease.

The AHA group described CKM syndrome by increasing stages of risk with corresponding differences in care goals:

• Stage 0 (no risk factors): An entirely preventive focus based on the AHA Life's Essential 8 framework. Adults should be screened every 3-5 years to assess blood pressure, triglycerides, HDL cholesterol, and blood sugar.

• Stage 1 (excess body fat and/or impaired glucose tolerance or prediabetes): Healthy lifestyle and a goal of at least 5% weight loss. Screening every 2-3 years is advised.

• Stage 2 (metabolic risk factors present): Prevent progression to CVD and kidney failure by treating type 2 diabetes, high blood pressure, high triglycerides, or kidney disease. Yearly assessment of these risk factors is recommended.

• Stage 3 (early, asymptomatic CVD): Intensify prevention therapies and consider coronary artery calcium screening.

• Stage 4 (CVD with or without kidney failure): Individualized treatment for CVD with consideration for CKM syndrome conditions.

"The public health urgency associated with CKM syndrome is a consequence of the historically high prevalence of obesity and diabetes in both adults and youth, with a disproportionate burden in disenfranchised populations," wrote an AHA writing committee in the advisory in the journal Circulation.

Source: MedPage Today | Read full story