Here's Who's Most at Risk for the 'New' Type of Heart Disease Researchers Have Just Identified
Medicine doctor holding red heart shape in hand
Your body is more than a machine—it's who you are. However, your different parts and systems work together like a machine to keep you running.
If the heart isn't functioning as it should, it puts the kidneys at risk for disease. Healthcare providers have known this for years. Now, a new condition may better inform treatment for patients with multiple risk factors for both heart and kidney disease.
Earlier this month, the American Heart Association (AHA) identified the disease in an advisory. It's called cardiovascular-kidney-metabolic syndrome, or CKM.
It's a mouthful, but the AHA "suggests redefining CVD risk, prevention and management."
The introduction of CKM occurs when obesity rates continue to rise. According to CDC data, obesity prevalence in the U.S. surged from 30.5% to 41.9& from 199-2000 to 2017-March 2020. More than 68 million U.S. adults are living with at least two chronic health conditions, the CDC also notes.
"Rates of metabolic diseases such as obesity and diabetes are rising, especially in young adults," says Dr. Ashish Sarraju, MD, a preventative cardiologist at Cleveland Clinic. "There are significant health consequences with this, including kidney disease, heart disease and mortality.
The goal can't be understated: To save the lives of people at a higher risk of death from heart or kidney disease.
"The thought is that we needed to get together and start earlier on in the spectrum rather than treating the full-blown disease, which is costly and impacts a person's quality of life and survival," says Dr. William Lawson, MD, the director of preventive cardiology at the Stony Brook Heart Institute.
Knowing your risk can empower you to start conversations with your healthcare team. Here's what doctors want you to know about cardiovascular-kidney-metabolic syndrome or CKM.
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What Is Cardiovascular-Kidney-Metabolic Syndrome?
The name is a long one, isn't it? However, in lay terms, Dr. Sarraju says it helps doctors and patients take a more holistic look at a person's health. "It is a way to synthesize our understanding of how several factors, such as excess adiposity (obesity), high blood pressure, glucose control, kidney disease and heart disease, all interact with each other," Dr. Sarraju says.
The term may be new, but the important idea behind it is not, according to one doctor who was on the AHA Presidential Advisory on CKM.
"It is important to recognize that these health conditions are not isolated," explains Dr. Ian J. Neeland, MD, the director of cardiovascular prevention and co-director of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease for University Hospitals Harrington Heart & Vascular Institute. "They are interconnected and cause adverse health conditions that substantially increase the risk for heart disease over time."
Who Is Most at Risk for Developing CKM?
It's unclear just how many people are at risk for developing CKM. Everyone is at least in stage 0, which means, at minimum, patients and providers should have conversations about reducing risk factors for the disease. "Given the burden of obesity in our country, probably 50% or more are at least stage 1," Dr. Neeland says.
Another expert agrees the number is likely high—and rising. "It’s in the tens of millions currently and will only increase with time given our current lifestyles," says Dr. Jonathan Fialkow, MD, the chief of cardiology and deputy director of Miami Cardiac & Vascular Institute, part of Baptist Health South Florida.
Dr. Fialkow says people most at risk for developing CKM are those with obesity and elevated:
Blood pressure
Blood sugar
Triglycerides
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Stages of CKM
The AHA identified five stages (0-4) of CKM. Dr. Neeland says these stages are:
Stage 0: No risk factors. Doctor-patient teams will focus on prevention. entirely prevention-focused
Stage 1: Excess body fat and/or an unhealthy distribution of body fat, such as abdominal obesity and/or impaired glucose tolerance or pre-diabetes, including gestational diabetes in pregnant women.
Stage 2: Metabolic risk factors, including people with type 2 diabetes, high blood pressure, high triglycerides and kidney disease.
Stage 3: Early cardiovascular disease without symptoms, or subclinical CVD, in people with metabolic risk factors, kidney disease or people at high predicted risk for cardiovascular disease.
Stage 4: Symptomatic cardiovascular disease in people with excess body fat, metabolic risk factors or kidney disease.
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How To Reduce Your Risk of CKM
"Prevention pays off," says Dr. Lawson, noting that discussing risk factors and treatments—including prevention as the best one—is a significant goal of the AHA's decision to introduce CKM. Dr. Lawson says that consuming a Mediterranean diet that goes heavy on fruits and vegetables and light on saturated fats can reduce cardiovascular risk factors. Exercise is also important: The AHA recommends 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week.
A tip? Don't feel like you have to jog in the morning because your pal does or splurge on a Peloton because your colleague still swears by it. "Swimming is good for people with orthopedic issues," Dr. Lawson says. He adds resistance training can also help improve bone health and strength.
More usual suspects make the list of expert recommendations for reducing CKM risk. Dr. Sarraju suggests following a heart-healthy lifestyle that includes "Adequate sleep, weight loss and smoking cessation."
"Seek help if needed to reduce excess adiposity and abdominal obesity," Dr. Sarraju says.
Communication between doctors and patients is a critical piece of the puzzle.
"Talk to your doctor about the syndrome, appropriate screening for the components of the syndrome and targeted interventions, like lifestyle or pharmacologic, to reduce the risk factor burden and progression to CKM disease," Dr. Neeland says.
In fact, Dr. Fialkow hopes that an increase in communication is one positive side effect of CKM.
"It may also result in more aggressive control for patients who have cardiac and kidney disease, as well as better coordination of care amongst caregivers," Dr. Fialkow says.
Next up: The #1 Sign Someone Is 'Aging Well,' According to a Geriatrician
Sources
Dr. Ashish Sarraju, MD, a preventative cardiologist at Cleveland Clinic
Dr. William Lawson, MD, the director of preventive cardiology at the Stony Brook Heart Institute
Dr. Ian J. Neeland, MD, the director of cardiovascular prevention and co-director of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease for University Hospitals Harrington Heart & Vascular Institute. He was on the AHA Presidential Advisory on CKM.
Dr. Jonathan Fialkow, MD, the chief of cardiology and deputy director of Miami Cardiac & Vascular Institute, part of Baptist Health South Florida.
