1 in 3 at Risk for Newly Identified Heart Syndrome

The American Heart Association has identified a new medical condition that signifies the strong association between obesity, heart, and kidney disease. The goal of labeling the disorder called cardiovascular-kidney-metabolic syndrome, or CKM, is to achieve early diagnosis for those at most risk of dying from cardiovascular disease.

“Reducing the pipeline of individuals progressing toward heart disease is our primary goal,” said Dr. Chiadi Ndumele, the lead author of the advisory released Monday and the director of obesity and cardiometabolic research at Johns Hopkins University, according to NBC News.

Ndumele says that increasing evidence shows how metabolic risk factors such as abdominal fat, high blood pressure, high cholesterol and high blood sugar negatively affect other organs of the body. Dr. Pam Taub, a cardiologist and professor of medicine at the UC San Diego School of Medicine says that identifying CKM is a “game changer” for high-risk patients.

Treating organs that are part of the syndrome with new medications has resulted in a decrease in cardiovascular events. For example, early kidney disease can be detected in a patient’s urine sample and drugs can be prescribed to prevent the progression to chronic kidney disease, said Taub.

When you look at the interaction of organs together, you can detect disease early and prevent devastating cardiovascular outcomes, she explained. Fortunately, people with the newly defined condition can improve if it’s detected early.

“Several times in my clinical practice I have seen regression after significant lifestyle changes and weight loss,” said Ndumele. He and this team developed a four-stage system for doctors to identify patients at risk:

• Stage 0: No risk factors for heart disease.

• Stage 1: People who are overweight with abdominal fat or who have pre-diabetes. These patients would be advised to follow a healthy lifestyle, with a goal of at least 5% weight loss.

• Stage 2: Someone with Type 2 diabetes, high blood pressure, high triglycerides, or kidney disease. Treatments would include medications to control blood pressure, blood sugar, and cholesterol. Patients may also be prescribed diabetes drugs such as SGLT2 inhibitors, which protect kidney function, and GLP-1 receptor agonists, such as Ozempic or Wegovy, to help control blood sugar or lose weight.

• Stage 3: People with metabolic risk factors such as high blood pressure and early cardiovascular disease or kidney disease but who are asymptomatic. Treatments may include heart and diabetes medicines, as well as testing for narrowing of the arteries.

• Stage 4: Someone with diagnosed heart disease, excess body fat, metabolic risk factors, or kidney disease. These patients may already have had heart attacks or strokes or may have suffered heart failure. People at Stage 4 would fall into one of two categories: those without kidney failure and those with it, says NBC News. Treatment would be appropriate for each category.

Ndumele estimates that a full 90% of U.S. adults falls on the CKM spectrum based on our record levels of obesity and Type 2 diabetes in both adults and children.

According to the American Heart Association presidential advisory, one in three U.S. adults have three or more risk factors that contribute to cardiovascular disease, metabolic disorders and/or kidney disease. CKM affects nearly every major organ in the body, including the heart, brain, kidney, and liver. However, the biggest impact is on the cardiovascular system, affecting blood vessels and heart muscle function, the rate of fatty buildup in arteries, electrical impulses in the heart, and more.

“The advisory addresses the connections among these conditions with a particular focus on identifying people at early stages of CKM syndrome,” noted Ndumele. “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.”