What Is CKM Syndrome? New Syndrome Affects 90 Percent of Americans

Cardiovascular-Kidney-Metabolic (CKM) syndrome is a newly recognized health condition defined by the American Heart Association (AHA) in 2023. It describes the strong interconnections among heart disease, kidney disease, type 2 diabetes, and obesity. These conditions often overlap and worsen each other, creating a cycle that significantly increases the risk of serious complications like heart attacks, strokes, heart failure, and kidney failure.

As of 2025, CKM syndrome affects a staggering portion of the population: nearly 90% of U.S. adults have at least stage 1 or higher, with about 15% in advanced stages (3 or 4). Globally, similar patterns are emerging, highlighting the need for integrated prevention and management.

Why CKM Syndrome MattersTraditionally, heart disease, kidney disease, and metabolic conditions like diabetes and obesity were treated separately. The AHA's CKM framework shifts this to a holistic approach, recognizing that poor health in one area accelerates problems in others. This leads to higher rates of premature morbidity and mortality. Early detection and coordinated care can prevent progression and improve outcomes.The 4 Stages of CKM SyndromeThe AHA outlines a progressive staging system (0–4) to assess risk and guide interventions:

• Stage 0: No CKM risk factors (ideal weight, blood pressure, blood sugar, lipids, and kidney function). Focus: Primordial prevention through healthy habits.
• Stage 1: Excess or dysfunctional body fat (e.g., overweight/obesity, especially abdominal). Focus: Lifestyle changes for weight management.
• Stage 2: Metabolic risk factors (e.g., high blood pressure, high triglycerides, type 2 diabetes, metabolic syndrome) or moderate-to-high-risk chronic kidney disease. Focus: Treat risks aggressively to prevent progression.
• Stage 3: Subclinical cardiovascular disease (early signs without symptoms) or very high-risk CKD/high predicted CVD risk. Focus: Intensive prevention and screening.
• Stage 4: Diagnosed cardiovascular disease (e.g., heart attack, heart failure, stroke) with CKM factors. Focus: Comprehensive treatment and multidisciplinary care.

Symptoms and Risk FactorsCKM syndrome often develops silently. Early signs may include:

• Fatigue or shortness of breath
• Swelling in legs/ankles (edema)
• High blood pressure
• Elevated blood sugar
• Unexplained weight gain

Key risk factors: Obesity, poor diet, inactivity, smoking, family history, and social determinants like food insecurity or limited healthcare access.Prevention and Lifestyle ChangesThe best defense is prevention, especially in early stages. Follow the AHA's Life's Essential 8:

Life’s Essential 8 includes the 8 components of cardiovascular health: 

1. healthy diet (e.g., Mediterranean-style: fruits, vegetables, whole grains, lean proteins)
2. participation in physical activity, 
3. avoidance of nicotine, 
4. healthy sleep, 
5. healthy weight (BMI)
6. healthy levels of blood lipids, 
7. blood glucose, and 
8. blood pressure.

Treatment Options in 2025Treatment is stage-dependent and multidisciplinary (cardiologists, nephrologists, endocrinologists). Beyond lifestyle:

• Medications for blood pressure, cholesterol, and blood sugar
• Emerging therapies: GLP-1 receptor agonists (e.g., semaglutide/Ozempic) and SGLT2 inhibitors (e.g., dapagliflozin) and provide multi-organ protection—reducing risks for heart, kidney, and metabolic issues.

Outlook and Next StepsWith early intervention, progression can be slowed or halted. Talk to your doctor about CKM screening, especially if you have risk factors. 
Always consult a healthcare professional for personalized advice.