Abstract P392: Cardiovascular-Kidney-Metabolic Syndrome Burden and Disparities in the 2011-2020 National Health and Nutrition Examination Survey

Background: Cardiovascular-kidney-metabolic (CKM) health is a new concept that reflects the interconnectedness of metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). The differences in poor CKM health by race/ethnicity in the US population have not been completely elucidated. Objective: To examine racial/ethnic differences in CKM stages among persons in the United States using large, nationally representative data. Methods: We cross-sectionally examined ≥18 years from the 2011-2020 National Health and Nutrition Examination Survey (NHANES). The outcome of interest was CKM syndrome, which we defined as the presence of at least one metabolic risk factor, CKD, or clinical CVD, and categorized into stage 0, stage 1, stage 2-3, and stage 4; each category was computed as a binary outcome. Our exposure was self-reported race/ethnicity, categorized as non-Hispanic White, non-Hispanic Black, Hispanic, or non-Hispanic Asian adults. Survey-weighted multivariable logistic regression was used to estimate racial/ethnic differences across CKM stages, adjusted for age, sex, and socioeconomic status. Results: Among 27,662 adults, mean age was 47±16 years, 52% female, and 94% had stage 1 CKM or worse. In the fully adjusted models, Black and Hispanic adults had a significantly higher likelihood of CKM syndrome across all CKM stages compared to White adults, while Asian adults had lower odds of CKM ( Table ). Compared to White adults, the odds of stage 2-3 CKM was 2.67 (95%CI: 1.83-3.90) among Black adults and 1.58 (95%CI: 1.14-2.19) among Hispanic adults. Similarly, the odds of stage 4 CKM was 1.70 (95%CI: 1.14-2.53) among Black and Hispanic adults. Conclusion: Racial/ethnic disparities were evident across CKM stages and most pronounced for Black and Hispanic persons. These results underscore the disproportionate burden of CKM faced by Black and Hispanic populations and highlight the need for concerted efforts to address these unequal risks.