HIGH PREVALENCE OF THE CARDIOVASCULAR-KIDNEY-METABOLIC SYNDROME

Objective: The cardiovascular-kidney-metabolic (CKM) syndrome has defined recently as the clinical picture characterized by obesity, diabetes, chronic kidney disease (CKD) and the cardiovascular (CV) sequelae including coronary heart disease, stroke, peripheral arterial disease, heart failure and atrial fibrillation. The continuum of CKM reaches from stage 0 with no risk factors to stage 4 with clinical CV disease. The aim of this study was to define the prevalence of the stages 0 – 2 of the CKM syndrome in the general population, according to age and sex and to explore the development of the prevalence over the last twenty years. Design and method: We used data provided by NHANES. NHANES is a biannual survey, which is representative for the non-institutionalized, civil population of the United States of America. We included non-pregnant participants aged 18 or older from 10 NHANES cycles between 1999 and 2020. We accounted for the complex survey design, as specified in the National Center for Health Statistic analytic guideline. All analyses were conducted using R version 4.3.2. Results: 7.9% of US adults were without any CKM risk factors and fulfilled the inclusion criteria for CKM Syndrome Stage 0, with the majority being female, comprising 64% of this subgroup. A higher percentage of younger participants were categorized in this group, with 74.9% being under the age of 45. 18.3% of the population encountered issues related to excess or dysfunctional adiposity (Stage 1) with a similar distribution between sexes. Over half of the US adult population (56.5%) exhibited either metabolic risk factors, CKD, or a combination of both and met the criteria for inclusion in stage 2. 49.3% were female and 50.7% were male. Older individuals were more prevalent in Stage 2. Conclusions: CKM syndrome is highly prevalent in the general population. Its prevalence rises with age and is modified by sex. Given the high prevalence of the CKM syndrome, especially in stage 2, reflecting patients at varying risk without subclinical or clinical CV disease, additional risk assessment is mandatory to tailor preventive measures on the population level to efficiently reduce cardiovascular morbidity and mortality.