What is CKM syndrome?

The American Heart Association first warned healthcare providers about CKM syndrome in October. The condition affects major organs in the body, including the brain, heart, liver, and kidneys.

CKM syndrome is diagnosed in five stages:

• Stage 0, characterized as having no risk factors for heart disease.
• Stage 1, characterized as a person having excess body fat and higher than normal blood sugar, but not high enough blood sugar to be considered diabetic.
• Stage 2, characterized as a person with type 2 diabetes, high cholesterol, and high blood pressure.
• Stage 3, characterized as a person having issues with heart and blood vessels, but no noticeable symptoms.
• Stage 4, characterized as a person having CKM risk factors as well as signs of heart disease, including coronary heart disease, heart failure, stroke, or atrial fibrillation. This stage also includes Stage 4a, which includes people without kidney failure, and Stage 4b, which includes people with kidney failure.

Study details

For the study, researchers from Brigham and Women's Hospital and Harvard Medical School analyzed nearly a decade's worth of data from more than 10,000 people who participated in the National Health and Nutrition Examination Survey.

They found that:

• 10.6% of people met the criteria for stage 0.
• 26% met the criteria for stage 1.
• 49% met the criteria for stage 2.
• 5% met the criteria for stage 3.
• 9% met the criteria for stage 4.

According to the researchers, the 15% of participants who had advanced CKM syndrome remained relatively constant between 2011 and 2020.

The researchers also found that participants over the age of 65 were more likely to be at an advanced stage of CKM syndrome than people between the ages of 45 and 64. However, only 18% of people ages 20 through 44 were at stage 0 of CKM, meaning they had no risk factors.

Discussion

Rahul Aggarwal, a cardiology fellow at Brigham and Women's and co-author of the study, said the researchers were "surprised that almost 90% of people met the criteria. It was much higher than we anticipated in a database that included younger adults."

Aggarwal said one of the biggest risk factors contributing to the percentage of people in advanced stages of CKM syndrome "is not improving obesity, which is very prevalent in the U.S." He added that 40% of people in the United States are obese. Another 32% are overweight, based on body mass index calculations from CDC.

Aggarwal added that findings show healthcare providers need to pick up on these conditions earlier "before they lead to downstream effects," like increased risk of heart attack, heart failure, and stroke. "We need to diagnose earlier and be more aggressive at treating people."

Sripal Bangalore, a professor of medicine and director of invasive and interventional cardiology at NYU Langone Health, said it's "alarming that 90% of the population is at least stage 1 and only 10% have no risk factors."

Bangalore similarly blamed the overweight and obesity epidemic for those results.

"We have a lot of work to do to reduce the rates of overweight and obesity," he said. "If we can do that, then hopefully we can reduce the number of people who progress to stage 2 and also move the needle down for higher stages."

Given how prevalent CKM syndrome is, healthcare providers should screen for the disease early and often, using people's BMI as well as lifestyle choices and family history, according to Latha Palaniappan, a professor of cardiovascular medicine at Stanford Medicine.

"Investing in preventive medicine — namely nutrition and exercise — may be the key to lessening the burden of CKM syndrome and CKM syndrome risk factors like obesity, particularly among high-risk populations," she said.

This new, broader approach to heart disease will likely help identify more people who are at risk, according to Robert Rosenson, director of lipids and metabolism at Mount Sinai Health System.

"The main message from this study should be that many common behaviors are leading to an accumulation of diseases over one's lifetime, which will impact quality of life and survival," he said. (Carroll, NBC News, 5/8; Ries, Healthline, 5/8; Mundell, U.S. News & World Report, 5/8)

Advisory Board cardiovascular resources

To learn more about the cardiovascular space, check out Advisory Board resources, including:

• This cheat sheet, which provides Advisory Board's predictions on key drivers, volume outlooks, and strategic imperatives that are driving (or slowing) growth in cardiovascular service lines.
• This research, in which we gathered 73 cardiovascular leaders to learn the most innovative strategies in cardiovascular care.
• This case study, which dives into how AdventHealth adjusted their cardiovascular ambulatory surgery center strategy.
• This slide deck, which will provide you with a ready-to-use presentation that will help you understand the major trends impacting cardiovascular care and implications for cross-industry stakeholders.

This webinar, occurring on May 23 at 1 p.m. ET, which will teach you about the newest trends in cardiovascular medicine and how they impact the future of care delivery.