High Prevalence of the Cardiovascular-Kidney-Metabolic Syndrome Among US Adults From 1999-2020 - An analysis of the NHANES survey

Abstract Background The cardiovascular-kidney-metabolic (CKM) syndrome is a newly defined chronic health condition from American Heart Association. We assessed the prevalence of CKM syndrome stages 0-2, which have not yet progressed to cardiovascular disease (stage 3-4) with trends analysis over the past two decades. Methods We used cross-sectional data provided by National Health and Nutrition Examination Survey. including non-pregnant participants aged 18 or older between 1999 and 2020. Weighted prevalence was analyzed over the course of the past 20 years and by population subgroup (including age, sex, and race/ethnicity). Results A total of 32848 US adults were included in our study (weighted mean age, 47.3 years; women, 51.3%). 7.9% of US adults were at stage 0 without any CKM risk factors, with 64% of this subgroup being female. 18.3% of US adults were classified as stage 1 with issues related to excess or dysfunctional adiposity without other metabolic risk factors or chronic kidney disease (CKD). More than half of the US adults (56.5%) exhibited either metabolic risk factors, CKD, or both (stage 2). Between 1999 and 2020, the CKM features increased with decreasing prevalence of stage 0 (P for trends =0.0018), not only in females but also in males. Conclusions Our findings illustrate an exceptionally high and increasing prevalence of CKM syndrome among US adults. This emphasizes the importance of comprehensive preventive strategies targeting the life style of large parts of the population. Moreover, further risk assessment should be implemented into stage 2 cohort to define patients with exceptional cardiovascular risk. Clinical Perspective What is new? CKM syndrome is a common chronic health condition in the general population. However, the prevalence of different CKM stages using real-world data has not been reported within the general population or its subgroups. The prevalence of CKM syndrome was increasing over the past two decades. The majority of US adults were classified as stage 2. A specific population remained undefined according to the current detailed definition of each CKM syndrome stage. What are the clinical implications? The high and increasing prevalence of CKM syndrome necessitates more precise preventive strategies, tailored to different target groups with consideration of age-, sex-, and gender-disparities. Given that approximately half of the study population fell into stage 2 with a wide spectrum of risk factors, it is imperative to identify patients with exceptionally high risk through additional risk assessments. This approach would facilitate the implementation of intensified treatment measures aimed at preventing the progression to cardiovascular disease (CKM syndrome stages 3-4).