The American Heart Association's 2026 statistics update reveals a significant public health concern: millions of Americans are unaware they have diabetes or chronic kidney disease, both major risk factors for heart disease. According to the report, nearly one in four U.S. adults with diabetes are undiagnosed, while Centers for Disease Control data indicate as many as 90% of adults with chronic kidney disease don't know they have it. This lack of awareness is particularly dangerous because these conditions are closely linked through cardiovascular-kidney-metabolic syndrome, or CKM syndrome.
The connection between heart disease, kidney disease and metabolic disorders means having one condition often increases the likelihood of developing the others. Shared risk factors include high blood pressure, high cholesterol, high blood sugar, excess weight and reduced kidney function. The Association's statistics report indicates screening for kidney disease could be improved, as two-thirds of patients with high blood pressure or diabetes are unaware they also have kidney disease due to lack of uACR testing, a urine test for kidney function.
"We are encouraging people to become aware of the connection between conditions so they and their health care team can think about their overall health beyond individual conditions," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "Understanding the connection helps you better prevent complications through lifestyle changes and appropriate treatment." The biggest health threats from CKM syndrome are disability and death from heart disease and stroke, which make up the "cardiovascular" part of CKM.
Regular screening of cardiovascular, kidney and metabolic health can catch problems early, as approximately 80% of heart attacks and strokes are preventable according to the American Heart Association. Risk factors often develop slowly with few or no symptoms initially. The Association's 2026 statistics report shows that about half of all U.S. adults have high blood pressure, about one in three has high total cholesterol, more than half have prediabetes or diabetes, over half have a high waist circumference, and about one in seven has kidney disease.
Screening for CKM syndrome may include blood pressure measurement, cholesterol panel, blood glucose testing, body weight and size measurements, and kidney function tests using both UACR and eGFR. A healthcare professional can put results from these tests into the PREVENT online calculator to estimate individual risk for cardiovascular disease over the next 10 or 30 years. CKM syndrome is preventable and treatable through healthy habits like those in Life's Essential 8 and evidence-based treatments that can improve multiple health conditions together.
The American Heart Association's Cardiovascular-Kidney-Metabolic Health Initiative is a specific effort to raise awareness of the connections between CKM syndrome conditions and improve diagnosis rates. The initiative, supported by founding sponsors Novo Nordisk and Boehringer Ingelheim, supporting sponsors Novartis Pharmaceuticals Corporation and Bayer, and champion sponsor DaVita, is enrolling 150 health care sites across 15 U.S. regions to participate in learning and sharing best practices for interdisciplinary care of CKM syndrome. It is expected to impact the care of more than a quarter-million patients.
