Prevalence and Cumulative Incidence of Mortality Associated with Cardiovascular-Kidney-Metabolic Syndrome in the United States

Abstract Background To inform public health policies regarding disease management, it is crucial to comprehend the prevalence and mortality rates linked to various stages of Cardiovascular-Kidney-Metabolic (CKM) syndrome. Methods A longitudinal study was conducted using National Health and Nutrition Examination Survey (NHANES) data (1999-2018) from 50,624 U.S. adults, defining CKM syndrome stages based on the 2023 American Heart Association (AHA) Presidential Advisory Statement. The investigation aimed to assess changes in 10-and 15-year adjusted cumulative incidences of cardiovascular mortality with each CKD syndrome stage and describe the cross-sectional prevalence of CKM syndrome from 1999 to 2020. Results CKM syndrome prevalence by stage was as follows: Stage 0, 12.5% (95% CI, 12.0-12.9); Stage 1, 16.7% (95% CI, 16.2-17.2); Stage 2, 40.0% (95% CI, 38.4-39.6); Stage 3, 22.9% (95% CI, 22.5-23.4); Stage 4, 8.9% (95% CI, 8.6-9.2). Over a median 9.5-year follow-up, 2,557 participants experienced cardiovascular death. The proportion of participants in Stages 0 and 3 decreased, while Stage 1 increased. The 15-year adjusted cumulative incidences of cardiovascular mortality were: Stage 0, 4.8% (95% CI 3.1-6.6); Stage 1, 5.3% (95% CI 4.0-6.6); Stage 2, 7.9% (95% CI 8.1-10.3); Stage 3, 9.2% (95% CI 8.1-10.3); Stage 4, 15.6% (95% CI 14.7-16.6). The absolute risk difference between CKM Stage 4 and Stage 0 at 15 years was 10.8% (95% CI 8.8-12.8). Conclusions Our findings showed a graded increase in cardiovascular mortality associated with each CKM stage. The trends observed by stage prevalence emphasize critical opportunities for stabilizing risk factors, thereby preventing adverse cardiovascular outcomes.