Cardiovascular-Kidney-Metabolic Syndrome in the US: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA that examined the prevalence of cardiovascular-kidney-metabolic (CKM) syndrome in US adults.

The study

Investigators used the National Health and Nutrition Examination Survey (NHANES; 2011 to March 2020) to identify adults aged 20 years and older who underwent physical examination and fasting laboratory measurements.

A total of 10 762 adults (mean age, 47.3 years; 51.8% women) were categorized into the following CKM syndrome stages:

• Stage 0: No CKM risk factors (eg, hypertension)

• Stage 1: Excess or dysfunctional adiposity

• Stage 2: Additional metabolic risk factors or moderate- or high-risk chronic kidney disease (CKD)

• Stage 3: Very high-risk CKD or high-predicted 10-year CVD risk

• Stage 4: Established CVD (eg, coronary artery disease)

The findings

Between 2011 and 2020, 10.6% of US adults met criteria for stage 0, 25.9% for stage 1, 49.0% for stage 2, 5.4% for stage 3, and 9.2% for stage 4.

When investigators analyzed the prevalence of CKM syndrome among the subgroups, they observed that adults aged 65 years and older were more likely to have advanced stages than were those aged 45 to 64 years (55.3% vs 10.7%; P < .001) and those aged 20 to 44 years (55.3% vs 2.1%; P < .001).

In addition, men were more likely than women to have advanced stages of CKM syndrome (16.9% vs 12.4%; adjusted prevalence ratio [PR] 1.36, 95% CI 1.24-1.49; P < .001). Black adults were significantly more likely to have advanced stages compared to White adults (18.9% vs 13.8%; adjusted PR 1.38, 95% CI 1.24-1.55; P < .001).

Authors' comment

"Poor CKM health is widespread in the US population, especially among Black adults. Equitable health care approaches prioritizing CKM health are urgently needed."

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