About 90% of U.S. adults meet the criteria for a newly recognized syndrome that comes from a combination of heart disease, kidney disease, type 2 diabetes and obesity.[1] This cluster of chronic health conditions is called cardiovascular-kidney-metabolic (CKM) syndrome. It can be prevented by paying attention to four health factors, according to scientific experts at the American Heart Association, a global force changing the future of health for all.
The four factors – blood pressure, lipids (cholesterol), body weight and blood sugar level - are part of the Association's Life's Essential 8™. These factors are mostly known for their connection to heart health, but they are also important for kidney and metabolic health. Good metabolic health means a person's body uses energy well, and these factors are in healthy ranges.
CKM syndrome demonstrates how the body's organs and systems depend on one another. When numbers are off in one area it affects the others, raising a person's risk for heart disease, stroke, kidney disease and metabolic conditions such as diabetes and obesity.
"The concept of cardiovascular-kidney-metabolic health reinforces how the four health factors are related to each other and how a holistic approach is needed for optimal health. This builds on the American Heart Association's Life's Essential 8 measures, which highlight the importance of the four health factors and four health behaviors to maintain cardiovascular health," said Sadiya S. Khan, M.D., M.Sc., FAHA, American Heart Association volunteer and a member of the science advisory group for the association's Cardiovascular-Kidney-Metabolic Health Initiative. The health behaviors in Life's Essential 8 are healthy eating, physical activity, avoiding tobacco and healthy sleep.
Khan is a Magerstadt Professor of cardiovascular epidemiology, an associate professor of cardiology and preventive medicine at Northwestern School of Medicine in Chicago.
Consider the following ways the four health factors are linked to CKM syndrome, and ways to keep them under control.
Blood Pressure
High blood pressure, also known as hypertension, happens when the force of blood pushing against the walls of blood vessels is too high. High blood pressure is a leading cause of heart disease, stroke and kidney disease.
High blood pressure doesn't have symptoms, so getting a blood pressure check is the only way to know if someone has it. Healthy blood pressure is below 120/80. If blood pressure is 130/80 or higher, talk to a health care professional about checking other health factors, too.
Changing what you eat and drink can help lower blood pressure. The Dietary Approaches to Stop Hypertension (DASH) eating pattern, which is low in fat and rich in fruits, vegetables, whole grains and low-fat dairy products, is proven to lower blood pressure. Reducing the amount of alcohol you drink also reduces blood pressure.
Cholesterol
Cholesterol is a waxy substance made in the liver that circulates in the blood where it's used to build cells and make vitamins and hormones. Cholesterol also comes from eating animal products. High levels of cholesterol increase the risk of type 2 diabetes, heart disease and stroke.
For optimal CKM health, LDL cholesterol should be below 100 and triglycerides below 150. Triglycerides are the most common type of fat in the body. If someone's triglyceride level is 135 or higher, ask a health care professional about reducing risk for diabetes and heart disease.
Losing body weight and increasing physical activity decreases triglyceride levels. In addition, DASH and Mediterranean (plant-based, high-fiber, low-fat) eating patterns support healthy LDL and triglyceride levels.
Body Weight
Healthy weight may be indicated by body mass index (BMI), a number that represents a person's weight in relation to their height. How a person's weight is distributed is also important. Excess weight around the waist can mean a higher risk for heart disease, stroke, high blood pressure, high cholesterol and diabetes.
CKM syndrome starts when BMI is 25 or higher and waist circumference is 35 in. (88 cm) or higher for women and 40 in. (102 cm) or higher for men.
To achieve and maintain a healthy weight, start by setting realistic goals. Understand how much and why you eat, manage portion sizes, make smart snack substitutions and be physically active.
Blood Sugar
High blood sugar leads to diabetes, which causes kidney damage over time. In fact, diabetes is the leading cause of kidney disease, and it increases the risk of heart attack and stroke.
Blood sugar is measured in two ways: a fasting blood glucose test (short-term blood sugar) and an A1C test (long-term blood sugar control). Healthy levels are fasting blood glucose of 70-99 and A1C below 5.7%. Fasting blood glucose above 125 or A1C of 6.5% or higher means a person has diabetes.
Habits that help to avoid high blood pressure, weight gain and high cholesterol also keep blood sugar levels in check. These are especially important for people with a family history of diabetes.
In July 2024, the American Heart Association announced the Cardiovascular-Kidney-Metabolic Health Initiative with foundational support from Novo Nordisk and Boehringer Ingelheim to increase awareness, education and treatment for CKM syndrome.
The initiative will be implemented in 15 geographic regions in the U.S, beginning with 150 health care sites where it is expected to impact more than a quarter-million patients.
Learn more about CKM syndrome at heart.org/CKMhealth.
