New guidance ties together heart disease, obesity, and kidney problems

The American Heart Association issued guidance on Monday redefining cardiovascular disease risk to coordinate care based on the links between the heart, kidneys, and metabolism better.

Cardiovascular-kidney-metabolic syndrome, or CKM, is a new way to describe the overlap in disease processes, helping practitioners make earlier diagnoses for improved intervention outcomes.

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“There is a need for fundamental changes in how we educate healthcare professionals and the public, how we organize care, and how we reimburse care related to CKM syndrome,” said Chiadi Ndumele, cardiometabolic research professor at Johns Hopkins University and lead author of the AHA advisory.

The move comes as a response to record-high levels of obesity and Type 2 diabetes, both of which are metabolic disorders that are also risk factors for poor cardiovascular health and kidney failure. The fragmented care for these conditions contributes to difficulties in early treatment.

“The advisory suggests ways that professionals from different specialties can better work together as part of one unified team to treat the whole patient,” Ndumele said in a press statement.

The advisory also provides a five-point ranked disease stage indicator to coordinate communication between practitioners and patients better. Those with habits of healthy eating, physical activity, and sleep who maintain optimal weight and blood pressure levels are listed as the “Stage 0” category, whereas those with excess levels of abdominal body fat or poor diet can be diagnosed as “Stage 1.”

Those with “Stage 2” already have certain metabolic disorders, including diabetes or obesity, that may require treatment with pharmaceuticals such as Ozempic or Wegovy. Those with chronic kidney disease would also fall into this category.

“Stage 3” involves asymptomatic cardiovascular disease, while “Stage 4” is symptomatic, with or without kidney failure.

Physician Natalie Azar told USA Today that this should be used as a framework for healthcare practitioners and patients.

“We can all look and say, ‘Where do I fit along here? Where do my patients fit along here?'” Azar said. “The point is not to progress. The point is to regress.”

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“Key partnerships among stakeholders are needed to improve access to therapies, to support new care models, and to make it easier for people from diverse communities and circumstances to live healthier lifestyles and to achieve ideal cardiovascular health,” Ndumele said.

The Centers for Disease Control and Prevention estimates that 6 million Americans have kidney disease. Nearly 700,000 people have cardiovascular disease. According to the CDC, one person dies every 33 seconds from cardiovascular disease.