Q&A: New initiative to address CKM syndrome, affecting millions in the US
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Key takeaways:
- Subclinical cardiovascular-kidney-metabolic syndrome affects the majority of the U.S. adult population.
- The AHA launched a 4-year effort to improve diagnosis and care of patients with CKM syndrome.
In October 2023, the American Heart Association unveiled the term cardiovascular-kidney-metabolic syndrome to reflect the connection between metabolic and renal conditions associated with risk for heart disease.
As Healio previously reported, the AHA simultaneously revealed an updated algorithm and guidance for screening, management and collaborative care for cardiovascular-kidney-metabolic (CKM) syndrome.
A recent study published in the Journal of the American College of Cardiology estimated that between 72% to 80% of the U.S. population have stage 1 CKM syndrome — excess and/or dysfunctional adiposity — to stage 3 CKM syndrome — subclinical CVD.
Supported by Novo Nordisk and Boehringer Ingelheim, the AHA launched a 4-year initiative to improve diagnosis and patient-centered care for individuals with CKM syndrome.
Healio spoke with Chiadi E. Ndumele, MD, PhD, FAHA, associate professor of medicine and director of obesity and cardiometabolic research at Johns Hopkins University, and chair of the AHA’s CKM science advisory group, about how this initiative plans to meet its goals.
Healio: Can you provide some background on this CKM syndrome initiative and how it was developed?
Ndumele: The CKM syndrome initiative developed in response to the realization that interconnected metabolic risk factors — obesity and diabetes — and chronic kidney disease are increasingly driving cardiovascular risk and cardiovascular disparities and contributing to worsening trends in cardiovascular mortality. Given the multi-system pathology seen in CKM syndrome, this necessitated a holistic, person-centered approach to care, considering multiple interrelated conditions, social determinants of health and the need for coordinated care approaches.
Healio: What does a person-centered approach to CKM syndrome look like?
Ndumele: A person-centered approach to CKM syndrome means not just focusing on individual systems, like the cardiovascular system alone or the renal system alone. Because of the interrelatedness of metabolic risk factors, chronic kidney disease and cardiovascular disease, patients typically experience clusters of these interrelated conditions. When subspecialists only focus on their own silos, this often leads to fragmented and poorly coordinated care. With CKM syndrome, we want providers to focus on the whole patient, and their interrelated health problems, and we want to facilitate collaborative and coordinated approaches to care. This is needed to effectively address the multisystem pathology in CKM syndrome.
Healio: How does the initiative intend to achieve the implementation of a person-centered approach to CKM syndrome?
Ndumele: The initiative will follow the framework provided by the CKM health Presidential Advisory published by the AHA in October 2023. There will be a focus on systematic screening for CKM risk factors, risk assessments through use of the PREVENT risk calculator and CKM staging, and initiations of therapies for CKM syndrome related to CKM stage and risk profiles. There will also be a focus on coordinated interdisciplinary care, with the support of CKM coordinators, and on systemic assessments of and support for adverse social determinants of health.
Healio: Is there a specific timetable of short-term goals over the next 4 years?
Ndumele: A multidisciplinary CKM Science Advisory Group will be helping to define major goals related to improving screening; ensuring systematic risk assessments; and implementing evidence-based, holistic and coordinated CKM syndrome care.
Healio: What are the roles of Novo Nordisk and Boehringer Ingelheim in this initiative?
Ndumele: Novo Nordisk and Boehringer Ingelheim are funders of this initiative. It will be very helpful for the AHA to have support from them in improving awareness, education, coordinated care and research for CKM syndrome.
Healio: Can you describe some of the major changes coming to Get With The Guidelines and the AHA’s outpatient data registries with this initiative?
Ndumele: There will be a growing focus on metrics related to CKM health, including screening, risk assessments and processes of care related to CKM syndrome. This will build on the foundation of great implementation work that AHA has already done to address risk related to risk factors like diabetes, hypertension and high cholesterol. There will also be an enhanced focus on outpatient assessments and care, since so many patients with CKM syndrome are encountered in the outpatient setting. This will support an emphasis on the prevention of cardiovascular and renal disease related to CKM syndrome.
Healio: Is there anything else you would like to add?
Ndumele: I am very excited that this initiative will support coordinated and holistic care for patients with CKM syndrome, which is driving so much of our modern-day trends in cardiovascular disease. This work is critical to helping individuals from diverse backgrounds to live longer and healthier lives. It has implications not only for individuals in the United States, but for the global population that is increasingly struggling with the challenges presented by CKM syndrome.
For more information:
Chiadi Ndumele, MD, PhD, FAHA, can be reached at cndumel2@jhmi.edu; X (Twitter): @chiadindumele.
References:
- Cardiovascular-kidney-metabolic health. https://www.heart.org/en/professional/cardiovascular-kidney-metabolic-health. Accessed July 24, 2024.
- Minhas AMK, et al. J Am Coll Cardiol. 2024;doi:10.1016/j.jacc.2024.03.368.
- New opportunity to improve diagnosis, care for people with cardiovascular-kidney-metabolic syndrome. https://newsroom.heart.org/news/new-opportunity-to-improve-diagnosis-care-for-people-with-cardiovascular-kidney-metabolic-syndrome. Published July 17, 2024. Accessed July 24, 2024.
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