Key result
Ideal Life's Essential 8 scores linked to ~45% lower risk of stage 4 CKM progression.
Why the study?
Cardiovascular-kidney-metabolic (CKM) syndrome provides an integrated framework for cardiometabolic and renal disease progression, yet the role of modifiable lifestyle factors in advancing from intermediate stages to overt clinical disease remains incompletely characterized.
Do modifiable lifestyle factors and higher Life's Essential 8 cardiovascular health scores reduce the risk of progression to stage 4 CKM syndrome (overt clinical cardiovascular disease) in older adults with stage 2 or 3 CKM syndrome?
Cohort (n=2,493)
Do modifiable lifestyle factors and higher Life's Essential 8 cardiovascular health scores reduce the risk of progression to stage 4 CKM syndrome (overt clinical cardiovascular disease) in older adults with stage 2 or 3 CKM syndrome?
In older adults with intermediate-stage (stage 2 or 3) CKM syndrome, regular physical activity (including walking, household chores, and gardening), avoiding heavy smoking, and achieving higher Life's Essential 8 scores are significantly associated with a lower risk of progressing to overt clinical cardiovascular disease (stage 4 CKM).
Answers are grounded in this paper and cite their sources.
Supports counseling older adults with intermediate CKM on lifestyle optimization; leaves open whether targeted behavioral interventions causally halt progression to overt cardiovascular disease.
Background : Cardiovascular–kidney–metabolic (CKM) syndrome provides an integrated framework for cardiometabolic and renal disease progression, yet the role of modifiable lifestyle factors in advancing to overt clinical disease remains incompletely characterized. Methods : We analyzed data from the Cardiovascular Health Study, a population-based cohort of U.S. adults aged ≥65 years. Participants with CKM stage 2 or 3 at baseline were followed for progression to stage 4 CKM, defined by incident clinical cardiovascular disease. Lifestyle exposures included physical activity, walking characteristics, household and leisure activities, smoking, sleep conditions, diet quality, and an overall Life’s Essential 8 (LE8)–based cardiovascular health index. Cox proportional hazards models estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results : Among 2,493 participants, greater physical activity was consistently associated with lower risk of CKM progression. Compared with no activity, low- and moderate-intensity activity were associated with reduced hazards (HR=0.71, 95% CI: 0.58-0.89 and HR=0.68, 95% CI: 0.55-0.86, respectively). Walking, faster walking pace, household chores, and gardening were inversely associated with progression. Heavy smoking (≥35 pack-years) was associated with higher risk, whereas sleep disturbances and sleep apnea were not. Higher LE8 index scores were strongly associated with lower risk; participants with ideal scores had a 45% lower hazard compared with those with poor scores (HR=0.55, 95% CI: 0.40-0.75). Conclusion : Among older adults with intermediate-stage CKM, regular physical activity and overall cardiovascular health were strongly associated with lower risk of progression to overt clinical disease, highlighting the importance of comprehensive lifestyle and risk factor optimization.
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Wang et al. (2026) conducted a cohort in Cardiovascular-kidney-metabolic (CKM) syndrome stage 2 or 3 (n=2,493). Ideal Life's Essential 8 (LE8) cardiovascular health index score (6-8 points) and modifiable lifestyle factors (physical activity, walking, household chores, gardening, smoking, diet, sleep) vs. Poor LE8 score (0-1 points) or unexposed reference group (no physical activity, non-smoking) was evaluated on Progression to stage 4 CKM, defined as incident clinical cardiovascular disease (coronary heart disease, heart failure, peripheral artery disease, atrial fibrillation, stroke, or transient ischemic attack) (HR 0.55, 95% CI 0.40-0.75). Ideal Life's Essential 8 scores (HR 0.55, 95% CI 0.40-0.75) and moderate physical activity (HR 0.68) were associated with lower risk of progression to stage 4 CKM in older adults.
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