TY - JOUR
T1 - A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome
T2 - A Scientific Statement from the American Heart Association
AU - Ndumele, Chiadi E.
AU - Neeland, Ian J.
AU - Tuttle, Katherine R.
AU - Chow, Sheryl L.
AU - Mathew, Roy O.
AU - Khan, Sadiya S.
AU - Coresh, Josef
AU - Baker-Smith, Carissa M.
AU - Carnethon, Mercedes R.
AU - Després, Jean Pierre
AU - Ho, Jennifer E.
AU - Joseph, Joshua J.
AU - Kernan, Walter N.
AU - Khera, Amit
AU - Kosiborod, Mikhail N.
AU - Lekavich, Carolyn L.
AU - Lewis, Eldrin F.
AU - Lo, Kevin B.
AU - Ozkan, Bige
AU - Palaniappan, Latha P.
AU - Patel, Sonali S.
AU - Pencina, Michael J.
AU - Powell-Wiley, Tiffany M.
AU - Sperling, Laurence S.
AU - Virani, Salim S.
AU - Wright, Jackson T.
AU - Rajgopal Singh, Radhika
AU - Elkind, Mitchell S.V.
AU - Rangaswami, Janani
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/11/14
Y1 - 2023/11/14
N2 - A growing appreciation of the pathophysiological interrelatedness of metabolic risk factors such as obesity and diabetes, chronic kidney disease, and cardiovascular disease has led to the conceptualization of cardiovascular-kidney-metabolic syndrome. The confluence of metabolic risk factors and chronic kidney disease within cardiovascular-kidney-metabolic syndrome is strongly linked to risk for adverse cardiovascular and kidney outcomes. In addition, there are unique management considerations for individuals with established cardiovascular disease and coexisting metabolic risk factors, chronic kidney disease, or both. An extensive body of literature supports our scientific understanding of, and approach to, prevention and management for individuals with cardiovascular-kidney-metabolic syndrome. However, there are critical gaps in knowledge related to cardiovascular-kidney-metabolic syndrome in terms of mechanisms of disease development, heterogeneity within clinical phenotypes, interplay between social determinants of health and biological risk factors, and accurate assessments of disease incidence in the context of competing risks. There are also key limitations in the data supporting the clinical care for cardiovascular-kidney-metabolic syndrome, particularly in terms of early-life prevention, screening for risk factors, interdisciplinary care models, optimal strategies for supporting lifestyle modification and weight loss, targeting of emerging cardioprotective and kidney-protective therapies, management of patients with both cardiovascular disease and chronic kidney disease, and the impact of systematically assessing and addressing social determinants of health. This scientific statement uses a crosswalk of major guidelines, in addition to a review of the scientific literature, to summarize the evidence and fundamental gaps related to the science, screening, prevention, and management of cardiovascular-kidney-metabolic syndrome.
AB - A growing appreciation of the pathophysiological interrelatedness of metabolic risk factors such as obesity and diabetes, chronic kidney disease, and cardiovascular disease has led to the conceptualization of cardiovascular-kidney-metabolic syndrome. The confluence of metabolic risk factors and chronic kidney disease within cardiovascular-kidney-metabolic syndrome is strongly linked to risk for adverse cardiovascular and kidney outcomes. In addition, there are unique management considerations for individuals with established cardiovascular disease and coexisting metabolic risk factors, chronic kidney disease, or both. An extensive body of literature supports our scientific understanding of, and approach to, prevention and management for individuals with cardiovascular-kidney-metabolic syndrome. However, there are critical gaps in knowledge related to cardiovascular-kidney-metabolic syndrome in terms of mechanisms of disease development, heterogeneity within clinical phenotypes, interplay between social determinants of health and biological risk factors, and accurate assessments of disease incidence in the context of competing risks. There are also key limitations in the data supporting the clinical care for cardiovascular-kidney-metabolic syndrome, particularly in terms of early-life prevention, screening for risk factors, interdisciplinary care models, optimal strategies for supporting lifestyle modification and weight loss, targeting of emerging cardioprotective and kidney-protective therapies, management of patients with both cardiovascular disease and chronic kidney disease, and the impact of systematically assessing and addressing social determinants of health. This scientific statement uses a crosswalk of major guidelines, in addition to a review of the scientific literature, to summarize the evidence and fundamental gaps related to the science, screening, prevention, and management of cardiovascular-kidney-metabolic syndrome.
KW - AHA Scientific Statements
KW - cardiovascular diseases
KW - diabetes, type 2
KW - heart diseases
KW - kidney failure, chronic
KW - metabolic syndrome
KW - obesity
KW - social determinants of health
UR - https://www.scopus.com/pages/publications/85176967790
U2 - 10.1161/CIR.0000000000001186
DO - 10.1161/CIR.0000000000001186
M3 - Review article
C2 - 37807920
AN - SCOPUS:85176967790
SN - 0009-7322
VL - 148
SP - 1636
EP - 1664
JO - Circulation
JF - Circulation
IS - 20
ER -