The first-ever clinical guideline for cardiovascular-kidney-metabolic syndrome, or CKM syndrome, was published today by the American Heart Association and the American College of Cardiology, identifying excess weight, particularly abdominal fat, as a key driver of the syndrome. The guideline aims to raise awareness of the interconnectedness of heart disease, kidney disease, and metabolic conditions such as diabetes and obesity.
Nearly 9 in 10 adults in the U.S. have at least one of the conditions within CKM syndrome, which includes high blood pressure, abnormal cholesterol, high blood glucose, reduced kidney function, and excess weight. As obesity rates continue to rise, the guideline underscores the importance of supporting a healthy weight and calls on healthcare professionals to initiate prevention-focused conversations with patients about how managing weight now can prevent future health problems.
“In terms of CKM health, weight is not just about a number on a scale — people with the same body weight can have very different health profiles,” said Chiadi E. Ndumele, M.D., Ph.D., chair of the writing committee for the guideline. “Rather, what’s most important is how fat tissue affects your metabolic health.”
The guideline replaces the 2013 guideline for managing overweight and obesity and builds on the American Heart Association’s 2023 definition of CKM syndrome. Ndumele noted that while many people may know they have heart disease, kidney disease, or diabetes, they may not realize how closely these conditions are connected. Having one increases the risk of others, and obesity raises that risk further.
The guideline emphasizes that prevention is as important as treatment. “We are saying that prevention is as important, if not more important, than treatment,” said Ambar Kulshreshtha, M.D., Ph.D., a volunteer member of the Heart Association’s Council on Quality of Care and Outcomes Research and a primary care physician who helped write the guideline. Excess abdominal fat can cause inflammation, leading to insulin resistance and vascular problems. If caught early, the disease process in CKM syndrome can be stopped or reversed.
The guideline offers ways for healthcare professionals to discuss weight non-judgmentally, starting with a question like, “Is now a good time for us to address your weight and your health and how they may be affecting each other?” It also outlines the use of effective medications such as SGLT2 inhibitors, GLP-1 based therapies, and nonsteroidal mineralocorticoid receptor antagonists.
To improve care coordination, the guideline recommends using CKM coordinators or navigators to bridge communication between patients, primary care clinicians, and specialists. “People with CKM syndrome don’t experience one condition at a time — it often all hits at the same time,” said Fatima Rodriguez, M.D., M.P.H., vice-chair of the guideline writing committee. The guideline also emphasizes identifying social barriers to healthy lifestyle and quality healthcare.
“Our goal here is to shift some of our paradigms, to not just wait for the disease to come to us, but rather to help individuals prevent a lot of disease in the long term,” Ndumele said.
For more information, visit the American Heart Association and the original release.
