Managing patients with cardiovascular-kidney-metabolic syndrome: a guideline-driven practical guide for primary care physicians

Cardiovascular-kidney-metabolic (CKM) syndrome is a systemic disorder characterized by an overall reduction in cardiovascular health that occurs as a result of the development of ≥2 cardiovascular, kidney, or metabolic risk factors. Prevalence of CKM syndrome and its contributing conditions is rising, carrying an associated increase in excess morbidity, premature mortality, and direct and indirect health-related expenditures for patients, particularly for individuals with adverse social determinants of health. The growing body of evidence supporting CKM syndrome as a single, multifactorial disease underscores the importance of implementing an overarching, interdisciplinary therapeutic approach for the prevention and management of each facet of the disease. The recent development of several therapies with multiple benefits for cardiovascular, kidney, and metabolic health provides an important opportunity to facilitate the development of treatment plans that address the root cause of CKM syndrome for patients in early stages and to alleviate symptoms, delay progression, and improve quality of life in later stages of the syndrome. These developments provide a challenge for primary care physicians (PCPs) to ensure they are managing patients at their current disease stage, with the most appropriate combination of therapies available. This review aims to provide PCPs with a guideline-driven, practical guide to facilitate these decisions on the most appropriate management path for different scenarios for patients with CKM syndrome.