What if your risk for heart disease isn't just about your heart?

Many people know they should keep an eye on their blood pressure and cholesterol. But about 9 in 10 U.S. adults haven’t heard of a condition that connects long-term heart health to their kidneys, blood sugar, weight and even mental health. And this newly defined condition affects nearly up to 90% of adults. Understanding Cardiovascular-Kidney-Metabolic (CKM) Syndrome can help you know your health risks, ask better questions at your next doctor's appointment, and better understand the factors that may influence your overall well-being.

What Is CKM Syndrome?

CKM stands for cardiovascular, kidney and metabolic health. The cardiovascular system includes the heart and blood vessels. The kidneys help filter waste from the blood and support other important body functions. The metabolic system refers to the processes the body uses to create, store and use energy.

CKM Syndrome conditions can include cardiovascular disease, kidney disease, obesity, diabetes and stroke. Looking at these health issues together rather than treating each one in isolation can be helpful for an overall health plan.

Why These Connections Matter

When one or more body systems do not function well, the risk for additional health problems may increase. As CKM Syndrome progresses, individuals may face a greater likelihood of conditions such as heart failure, heart attack, stroke, kidney disease, atrial fibrillation (an irregular heart rhythm) and peripheral artery disease, which affects blood flow to the limbs.

One of the biggest challenges is that several of these conditions may develop with few noticeable symptoms. For that reason, screening and routine health assessments can play an important role in identifying risk factors and changes in health status.

Understanding Common Health Measurements

Routine tests and measurements can provide useful information about current health and may help identify conditions that warrant further evaluation.

Common measurements include:

• Blood glucose (blood sugar) levels
• Blood pressure
• Cholesterol and triglyceride levels
• Urine tests that look for signs of kidney damage
• Blood tests that assess kidney function
• Body mass index (BMI) or waist circumference measurements

In some cases, these measurements may be one of the earliest indicators that a person is developing CKM-related health concerns.

The Stages of CKM Syndrome

Four stages reflect changes in heart, kidney and metabolic health, and it is possible to move between stages as health changes over time. Early identification and appropriate care may help slow progression and, in some cases, improve certain aspects of health.

• Stage 0 represents individuals who do not have CKM syndrome and are focused on maintaining good health.
• Stage 1 includes people with excess body weight, prediabetes or insulin resistance, which means the body is beginning to have difficulty regulating blood sugar.
• Stage 2 includes conditions such as Type 2 diabetes, high blood pressure, elevated triglycerides, chronic kidney disease or metabolic syndrome.
• Stage 3 involves signs of damage affecting the heart, blood vessels or kidneys that may be identified through testing, even when symptoms are not present.
• Stage 4 includes people who have been diagnosed with cardiovascular diseases such as heart failure, stroke, coronary heart disease, atrial fibrillation or peripheral artery disease.

How Health Conditions Can Build on One Another

One of the central ideas behind CKM syndrome is that health conditions often do not occur in isolation. A person may start with one risk factor, such as excess weight or elevated blood sugar, and later develop additional conditions that affect the blood vessels, kidneys or heart. Over time, these conditions can interact, creating additional challenges for overall health.

Health Conditions That May Influence CKM Health

Other conditions that may influence CKM syndrome risk, progression, or treatment decisions include chronic inflammation, certain autoimmune conditions, sleep disorders such as obstructive sleep apnea, depression, anxiety, reproductive health factors and a liver condition known as metabolic dysfunction-associated steatotic liver disease (MASLD).

In addition, a person’s family history, social circumstances and access to healthcare resources may affect their overall risk and health outcomes.

Treatment and Lifestyle Considerations

Treatment plans for CKM syndrome are individualized and developed with a healthcare team who can help evaluate individual risks and benefits. First steps may include lifestyle adjustments such as nutrition, physical activity and weight management. Ask your doctor about options for lowering blood pressure, improving cholesterol levels, increasing physical activity or managing weight as appropriate to your situation.

The Importance of Mental Health

Because mental and physical health are connected, depression and anxiety may influence CKM syndrome progression. If you have concerns about your mental health, please discuss them with your healthcare team and seek appropriate support when needed.

A Team-Based Approach to Care

Because CKM syndrome can affect multiple body systems, care often involves a variety of healthcare professionals. Depending on an individual's needs, the care team may include primary care providers, cardiologists, kidney specialists, endocrinologists, dietitians, pharmacists, mental health professionals and other specialty care providers. A team-based approach can help coordinate care across different aspects of health.

The Bottom Line

While every person's situation is unique, learning about CKM health can be a useful first step in making informed decisions about disease prevention, risk and overall well-being.