Objective: Cardiovascular-Kidney-Metabolic syndrome (CKM syndrome) is a complex health condition where Heart Failure (HF), chronic kidney disease (CKD), and metabolic issues like type 2 diabetes (T2D) and hypertension (HTN) coexist, creating a vicious cycle that significantly increase the risk of future cardiovascular and renal events. In Kazakhstan, HTN prevalence is high and is a leading cause of HF. On the contrary, real-world data on CKD and CKM multimorbidity are still scanty. Thus, epidemiological characterization, therapeutic protocols and clinical outcomes have been poorly described by collecting real-world evidence in this country. Purpose. To give and updated snapshot about the complex relationship among HTN, T2D HF, and CKD in Kazakhstan individuals enrolled in the iCaReMe global registry, an investigator-led, prospective, real-world registry. Design and method: Socio-demographic data, clinical characteristics, comorbidities, and health outcomes with a specific focus on HTN, T2D, HF, and CKD, were collected from medical records of several clinical sites of Kazakhstan. Results: As of May 2025, 703 patients were enrolled (54% women; mean age 66 years,). Patients had HTN (65%), HF (15%), T2D (14.5%), and CKD (6%). Most patients were overweight, and multimorbidity was highly prevalent. Overall, 662 (94%) of the 703 patients had HTN as a comorbidity (HTN with or without CKD, T2D, HF) and 63 patients (9%) had all four conditions. Among patients with Heart Failure, HF with preserved ejection fraction predominated (54%), followed by HF with reduced (24%) and mildly reduced (22%) ejection fraction. Women were older than men (67.5 vs 64.1 years, p<0.0001). Conclusions: This real-world analysis shows for the first time a substantial burden of hypertension-driven multimorbidity and pronounced cardiorenal clustering in Kazakhstan. The predominance of HTN and HFpEF highlights the need for integrated, multidisciplinary care models and earlier detection of CKD and cardiovascular disease. The iCaReMe registry might provide a critical platform to identify gaps in diagnosis and management and to inform future strategies for cardio-kidney-metabolic risk reduction.
Sugraliyev et al. (Fri,) studied this question.