Americans Urged to Screen for Cardiovascular-Kidney-Metabolic Syndrome Risk Factors

Some 90 percent of Americans have at least one risk factor for cardiovascular-kidney-metabolic – or CKM – syndrome, a term for potentially life-threatening conditions that are all connected.

Now, experts at the American Heart Association say more of the country should be screened for one particular risk factor in the first-ever clinical guidelines for the syndrome.

Excess body fat is a key driver for all of the conditions that make up CKM syndrome: obesity, cardiovascular disease, kidney disease and Type 2 diabetes, all of which are responsible for the deaths of millions of Americans each year.

“Heart, kidney and metabolic conditions don’t occur in isolation — they are deeply connected,” Dr. Chiadi Ndumele, director of obesity and cardiometabolic research at Johns Hopkins School of Medicine, explained in a statement.

“This guideline calls for earlier screening and care, focusing on prevention and coordinated action to reduce the risk of cardiovascular disease before serious complications develop or a major cardiac event occurs,” he said.

Excess weight can lead to harmful inflammation that contributes to the development of chronic disease, like cancer and heart disease.

That’s why maintaining a healthy weight is crucial, the association notes, to reduce the risk of CKM syndrome.

Dr. Ambar Kulshreshtha, an associate professor at the Emory School of Medicine, likened the problems caused by obesity to rust.

“The rust can damage the pipes, which is like your vascular system,” he said. “It can damage the pump, which is like your heart. And it can damage the filters, like your kidneys.”

Risk posed from excess fat should be measured by both a person’s waist circumference and body mass index, the standard way obesity is diagnosed, the guidance says.

While obesity screening starts at age 6, screenings for other CKM syndrome conditions typically don’t happen until later in life.

Screenings for heart disease typically start at age 20 for basic risk factors, but more intensive checks don’t begin until around age 40-45, the association notes.

Screening for Type 2 diabetes is recommended at age 35, while for kidney disease screening is recommended for older adults over the age of 60.

Previous research has found that earlier screening for kidney disease – starting as soon as age 35 – would save lives.

"[Chronic kidney disease] is often clinically silent until patients reach late-stage kidney disease, so many people with early-stage CKD are unaware they have it," Marika Cusick, a PhD candidate in health policy at Stanford Medicine, said in 2023.

"By screening for CKD, we can diagnose and treat it at an earlier stage, improving life expectancy and reducing the risk of progressing to late-stage kidney disease, which is deadly and costly,” she added.

Notably, lowering the screening ages for colorectal cancer and breast cancer have led to more diagnoses. Although, there are other contributors to increased disease cases that doctors are still studying.

Beyond keeping a healthy weight through diet and exercise and going in for more regular screenings, people should manage their blood pressure and cholesterol levels, get the federally recommended 7-9 hours of sleep and avoid tobacco products.