A new study published in the American Heart Association’s journal Circulation: Population Health and Outcomes reveals that people with advanced cardiovascular-kidney-metabolic (CKM) syndrome face a significantly higher risk of developing cancer. The research, which analyzed data from nearly 1.4 million adults in Japan, found that cancer risk increased by 25% for stage 3 and 30% for stage 4 CKM syndrome compared to those with no risk factors.
CKM syndrome encompasses a cluster of interconnected conditions including heart disease, stroke, kidney disease, obesity, and diabetes. According to the American Heart Association, nearly 9 out of 10 U.S. adults have at least one component of CKM syndrome, such as high blood pressure, abnormal cholesterol, high blood sugar, excess weight, or reduced kidney function.
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” said Hidehiro Kaneko, M.D., Ph.D., the study’s lead author and associate professor at the University of Tokyo. The researchers used national insurance claims data to stage participants according to the American Heart Association's Cardiovascular-Kidney-Metabolic Health presidential advisory framework, then tracked new cancer diagnoses over approximately 3.5 years.
Results showed that while early stages (1 and 2) carried only a 2-3% higher cancer risk, later stages saw a dramatic increase. Stage 3 CKM syndrome, which involves subclinical cardiovascular disease or high-risk metabolic factors, was linked to a 25% higher risk. Stage 4, defined by established cardiovascular disease such as heart attack or stroke, corresponded to a 30% higher risk.
“CKM syndrome represents a complex interplay among the cardiovascular, kidney and metabolic systems, where dysfunction in one area may trigger or exacerbate dysfunction in others,” Kaneko explained. “Dysfunction in each of these systems is independently associated with cancer risk due to shared risk factors.”
Tochukwu Okwuosa, D.O., director of cardio-oncology services at Rush University Medical Center and an American Heart Association volunteer, noted the bidirectional relationship. “We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease. The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk.” She added that the CKM syndrome staging framework may help flag high-risk individuals for potential cancer screenings.
The study’s limitation is that results from a Japanese population may not be fully generalizable, but the authors note that other research has consistently linked metabolic and kidney dysfunction to increased cancer risk. The findings reinforce the importance of addressing CKM syndrome holistically, as nearly every major organ system is affected, including links to kidney failure, dementia, fatty liver disease, and sleep apnea.
The American Heart Association receives more than 85% of its revenue from non-corporate sources, and its policies prevent donations from influencing science content. More information is available here.
