Long-term cardiovascular risk with cardiovascular-kidney-metabolic syndrome in U.S adults

Background Cardiovascular-kidney-metabolic (CKM) syndrome staging helps identify cardiovascular disease (CVD) risk. Determining how predicted CVD risks vary across CKM stages in the U.S can further improve understanding of disease progression and help guide prevention strategies. Methods We analyzed 2011–2020 NHANES data using survey-weighted quantile regression to compare total CVD risks predicted by the PREVENT equations across CKM stages. Results Among 12,349 CVD-free adults aged 30–79 (~122.8 million adults), median (25th – 75th) 10-year and 30-year CVD risks were 0.9% (0.5–2.1%) and 6.0% (3.3–10.1%) in Stage 0, 1.5% (0.7–3.3%) and 8.9% (4.7–14.9%) in Stage 1, 4.6% (2.0–9.2%) and 18.4% (0.4–26.3%) in Stage 2, and 23.5% (21.3–27.1%) and 51.6% (38.3–58.6%) in Stage 3 CKM, respectively. Higher CKM stage generally predicted higher CVD risks. Men had higher risks than women, while race/ethnicity differences were modest. Conclusion CVD risks estimated by PREVENT equations increase with higher CKM stage, supporting CKM staging for risk stratification.