A new study presented at the American Heart Association's Scientific Sessions 2024 reveals that people with chronic kidney disease, Type 2 diabetes, or both could face elevated cardiovascular disease risk 8 to 28 years earlier than those without these conditions. This research sheds light on the substantial impact of cardiovascular-kidney-metabolic syndrome on heart health throughout adulthood. Researchers used the American Heart Association's PREVENT™ calculator to estimate the age at which individuals with different risk profiles would reach an elevated CVD risk, defined as a 7.5% or higher chance of having a heart attack or stroke in the next 10 years. The study created simulated risk profiles for men and women aged 30 to 79 years, with and without chronic kidney disease and/or Type 2 diabetes.
The findings were striking. Without CKM syndrome, women were expected to reach elevated CVD risk at age 68, and men at age 63. However, those with CKM components showed significantly earlier onset of elevated risk. Adults with stage 3 chronic kidney disease were predicted to reach elevated CVD risk 8 years earlier than those without CKM syndrome. Those with Type 2 diabetes were predicted to reach elevated risk 9 years earlier for women and 11 years earlier for men. Most notably, adults with both Type 2 diabetes and stage 3 chronic kidney disease were predicted to reach elevated CVD risk at age 42 for women and 35 for men - 26 and 28 years earlier, respectively, than those without CKM syndrome.
Lead study author Vaishnavi Krishnan, B.S., a researcher at Northwestern University and medical student at Boston University School of Medicine, emphasized the importance of understanding how age interacts with risk factor levels to optimize CKM health. The study's findings could help interpret the combination of risk factors that lead to high predicted CVD risk and at what age they impact risk. This research is particularly significant given that nearly half of all U.S. adults are living with some form of CVD, and one in three has at least three risk factors contributing to CKM syndrome, according to the American Heart Association. Early identification of those at greatest risk can improve primary prevention efforts and reduce the risk of premature death from CVD.
While the study's strength lies in its examination of risk factors across nearly the full adult life course, it's important to note that these are predicted risk calculations based on a simulated population. Dr. Sadiya S. Khan, co-author of the study and associate professor at Northwestern School of Medicine, stated that this research is an early step in understanding how a risk model works, and future work and guidelines are needed to determine how to use the PREVENT equations in a clinical setting. To address the complex health threat of CKM syndrome, the American Heart Association has launched a four-year Cardiovascular-Kidney-Metabolic Health Initiative. This initiative aims to improve coordination among specialists, promote best practices, and implement guidelines and screening recommendations for CKM syndrome treatment.
As cardiovascular disease remains a leading cause of death worldwide, this research underscores the critical importance of early risk assessment and intervention, particularly for individuals with components of CKM syndrome. By identifying those at elevated risk decades earlier, healthcare providers may have a greater opportunity to implement preventive strategies and potentially alter the course of cardiovascular disease development. The study's implications extend beyond clinical practice to public health policy, suggesting that targeted screening and management of CKM syndrome components could significantly reduce the burden of cardiovascular disease across populations.
