Nearly 90 percent of Americans are at risk of Cardiovascular-Kidney-Metabolic (CKM) Syndrome, a potentially life-threatening condition that recognizes the link between conditions like diabetes, obesity, and high blood pressure, according to researchers. The syndrome, first named in 2023, underscores how these issues can collectively damage the heart, kidneys, brain, and liver.
CKM Syndrome emphasizes the interconnectedness of these organ systems, where the failure of one can exacerbate the others, creating a dangerous cycle. Individuals with CKM Syndrome face a heightened risk of heart attack, stroke, and heart failure, which can reduce life expectancy by up to seven years in severe cases.
"We want people to know that it's really common to have heart, kidney and metabolic risk factors at the same time," said Dr. Eduardo Sanchez, chief medical officer at the American Heart Association, which coined the term. "The heart, kidney and metabolic systems are connected and, as such, should be treated in a coordinated way. The condition emphasizes those connections and helps patients understand the importance of collaborative care."
Despite the widespread risk, surveys indicate that a vast majority of Americans have never heard of CKM Syndrome. The American Heart Association released the first guidelines for physicians on identifying and managing the condition in early 2024.
The broad definition of CKM Syndrome is designed to encompass individuals across a spectrum of health, from those with early metabolic risk factors to those already diagnosed with heart disease. Data indicates that over 110 million adults in the U.S. have high blood pressure, 100 million are obese, and 40 million have diabetes, with 90 percent of diabetes cases being type 2.
CKM Syndrome is categorized into four stages. Stage one involves individuals who may feel well but have excess abdominal fat and slightly elevated blood sugar, often referred to as prediabetes. These individuals typically have a body mass index of 25 kg/m2 or higher and specific waist circumference measurements.
Stage two is characterized by diagnoses of conditions often linked to excess body fat, such as high blood pressure, type 2 diabetes, abnormal blood fat levels, and metabolic syndrome. In stage three, patients may have asymptomatic heart disease, like atherosclerosis or early signs of heart failure, which may go undiagnosed due to a lack of symptoms. The fourth stage involves individuals diagnosed with established heart disease or who have experienced a heart attack, stroke, coronary artery disease, or heart failure.
Symptoms can include chest pain, shortness of breath, swelling in the extremities, and leg pain during walking. Those who are obese, have significant abdominal fat, high blood pressure, kidney disease, diabetes, or metabolic syndrome are considered most vulnerable.
The underlying cause is the release of inflammatory substances from excess fat tissue, which can damage the heart, kidneys, and arteries. A 2026 study predicted that individuals with stage four CKM Syndrome may live nearly seven years less than those without the condition.
Diagnosis involves tests assessing blood pressure, blood sugar levels, kidney function, and other relevant markers. Lifestyle changes, including diet and exercise to reduce excess body fat, are often the primary treatment. In more advanced stages, medications may be prescribed to manage blood pressure, cholesterol, and blood sugar. Surgeries for the heart, kidneys, or weight loss might be considered in advanced cases.
"CKM health is about your overall health," Sanchez added. "It's a full circle. You can take care of your overall health with regular checks of your blood pressure, cholesterol, weight, blood sugar and kidney function."