Cardiovascular
Prevalence of Cardiovascular-Kidney-Metabolic Syndrome in the United States: National Health and Nutrition Examination Survey 2011-2018 Jieun Kim* Jieun Kim Joseph J. Shearer Maryam Hashemian Kayode O. Kuku Carolina Downie Jungnam Joo Veronique L. Roger
Introduction
Cardiovascular-Kidney-Metabolic (CKM) syndrome is the result of a complex interplay between metabolic risk factors, chronic kidney disease, and cardiovascular disease. The American Heart Association (AHA) recently published definitions for CKM syndrome highlighting its progressive pathophysiology; however, the prevalence and patterns of these stages across key demographic factors in the United States remains to be fully described.
Objective
To assess the prevalence and patterns of CKM syndrome among adults in the United States.
Methods
We studied adults aged 20 years or older who completed the National Health and Nutrition Examination Survey between 2011-2018. Eligible adults (N=8,474) were classified by CKM stage using AHA criteria: stage 0 (no risk factors), stage 1 (excess or dysfunctional adiposity), stage 2 (other metabolic risk factors or chronic kidney disease), and stage 3-4 (subclinical or clinical cardiovascular disease). Weighting and sampling strata were used to generate population-based prevalence estimates and 95% confidence intervals for CKM syndrome stages, and stratified by age group, gender, and race/ethnicity.
Results
The median age of the population was 46.8 (32.8-60.3) years, 49.1% were male, and 65% were Non-Hispanic White. The prevalence of CKM syndrome by stage was as follows: stage 0 (10.5%, 95% CI: 9.4-11.7%), stage 1 (27.2%, 25.7-28.6%), stage 2 (52.8%, 51.0-54.5%), and stage 3-4 (9.5%, 8.6-10.4%). Compared to stage 0, adults in stage 3-4 were more likely to be older, male, and Non-Hispanic Black. The prevalence of stage 0 significantly decreased between 2011-2018.
Conclusion
Nearly 9 out of 10 adults in the United States live with or are at elevated risk of CKM syndrome emphasizing the striking public health burden of CKM syndrome in the United States. These results also identify critical disparities which in turn delineate pathways for urgent interventions aimed at slowing or reversing the progression of CKM syndrome.