Key result
Cardiovascular-kidney-metabolic syndrome affects ~89% of US adults, with widespread treatment gaps.
Why the study?
Contemporary national estimates of cardiovascular-kidney-metabolic (CKM) syndrome stage distribution, stage drivers, and treatment gaps were needed to inform implementation of the CKM framework.
Cross-Sectional (n=2,958)
Cardiovascular–kidney–metabolic syndrome affects nearly 90% of US adults, with substantial persistent gaps in blood pressure and lipid management across stages 2 through 4.
Answers are grounded in this paper and cite their sources.
Substantial CKM burden and gaps support enhanced screening in practice; extends national staging data while leaving intervention trials open.
Background Cardiovascular–kidney–metabolic (CKM) syndrome staging integrates adiposity, metabolic dysfunction, chronic kidney disease, and cardiovascular disease. Contemporary national estimates of CKM stage distribution, stage drivers, and treatment gaps are needed to inform implementation of the CKM framework. Methods We analyzed adults aged ≥20 years in the National Health and Nutrition Examination Survey 2021 to 2023 fasting subsample. CKM stage was assigned hierarchically using American Heart Association CKM staging criteria. We estimated survey‐weighted CKM stage prevalence, national population counts, stage‐specific drivers, and risk‐factor control and treatment gaps across stages 2 through 4. Results The analytic sample included 2958 adults, representing 245.2 million US adults. Overall, 26.4 million adults (10.8%) were stage 0, 56.8 million (23.2%) stage 1, 125.9 million (51.3%) stage 2, 13.4 million (5.5%) stage 3, and 22.7 million (9.3%) stage 4. Stage ≥1 was present in 89.2%, stage ≥2 in 66.1%, and advanced CKM (stages 3–4) in 14.7%. Among stage 1 adults, 85.1% had adiposity and 49.2% had prediabetes. Among adults with stage 2 CKM, hypertension (72.0%), metabolic syndrome (56.1%), and hypertriglyceridemia (41.9%) were common drivers. Among adults with stage 3 CKM, 95.8% met the Predicting Risk of Cardiovascular Disease Events 10‐year cardiovascular disease risk criterion. Risk‐factor control and treatment gaps were common across stages 2 through 4, including blood pressure ≥130/80 mm Hg in 50.3% to 66.9%, lipid‐lowering therapy nonuse among eligible adults in 30.1% to 59.2%, and low‐density lipoprotein cholesterol above the target in 64.5% to 73.9%. Conclusions CKM syndrome affects most US adults, with stage‐specific drivers and persistent risk‐factor control and treatment gaps. These findings provide contemporary benchmarks for CKM surveillance and implementation.
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Hyun et al. (2026) conducted a cross-sectional in Cardiovascular-kidney-metabolic (CKM) syndrome (n=2,958). American Heart Association CKM staging criteria vs. Across CKM stages 0 through 4 was evaluated on Survey-weighted CKM stage prevalence, stage-specific drivers, and risk-factor control and treatment gaps. Cardiovascular-kidney-metabolic syndrome (stage ≥1) affected 89.2% of US adults (66.1% stage ≥2; 14.7% stages 3-4), with widespread risk-factor control and treatment gaps.
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