New four-year initiative targets cardiovascular-kidney-metabolic syndrome

About 1 in 3 U.S. adults have at least three risk factors for cardiovascular-kidney-metabolic (CKM) syndrome, a health disorder related to the strong connections among cardiovascular disease, kidney disease and metabolic disease (such as Type 2 diabetes and obesity). Yet there is no single clinical practice guideline to treat people with CKM syndrome, and gaps exist in preventing, screening, managing and comprehensively treating these diseases.

To address this complex health threat, the American Heart Association, celebrating 100 years of lifesaving service as a global force for healthier lives for all, is creating a four-year Cardiovascular-Kidney-Metabolic Health (CKMH) Initiative to implement a person-centered approach to awareness, professional and patient education, and treatment of CKM syndrome.

The initiative, supported by Novo Nordisk and Boehringer Ingelheim, will assess gaps in clinical care, identify areas for future research and implement guidelines and screening recommendations to provide clear and definitive advice for treatment. The American Heart Association will collaborate on this with the American College of Physicians, American Diabetes Association®, American Society of Nephrology, National Kidney Foundation and STOP Obesity Alliance at the Milken Institute School of Public Health. The effort will engage 150 hospitals and sites across the nation, reaching more than 265,000 patients.

CKM syndrome was first defined by the American Heart Association in an October 2023 presidential advisory and scientific statement, both published in its flagship peer-reviewed scientific journal Circulation. As the underlying conditions of CKM syndrome worsen, the risk of heart attack, stroke, heart failure and kidney and liver diseases increases. 

Given the complexity and interconnectedness of CKM conditions, it is important to take a holistic approach, bringing best practices to life across the lived experiences of individuals and the health care professionals who treat them. "By having a person-centered focus that harmonizes care, we will be able to drive earlier identification of cardiovascular- kidney-metabolic conditions, implement better treatment and care, and increase awareness, knowledge and skill-building."

Mariell Jessup, M.D., FAHA, chief science and medical officer of the American Heart Association

Informed by the new clinical compendium, the Association will expand CKMH measures within its Get With The Guidelines® and outpatient data registries, as well as develop a CKM recognition program for individual health care professionals and health systems dedicated to improving CKM care. In collaboration with the Cardiometabolic Center Alliance, the American Heart Association will develop a scalable patient-centered certification supported by a national health system implementation science framework to improve treatment for CKM syndrome.

"Novo Nordisk is honored to work with the American Heart Association in advancing the CKMH initiative, addressing crucial gaps in screening, preventing and treating cardiovascular-kidney-metabolic syndrome," said Anna Windle, PhD, senior vice president, clinical development, medical and regulatory affairs, Novo Nordisk. "Our dedication to enhancing cardiometabolic health uniquely positions us to lead substantial change. We look forward to supporting the Association's CKMH Initiative focused on improving cross-specialty cooperation, promoting adherence to guideline-directed medical therapy and implementing best practices to bolster support for patients in this area of significant unmet need."

"Cardiovascular, kidney and metabolic diseases together represent one of the fastest growing health challenges of our time," said Carinne Brouillon, PharmD, MBA, head of human pharma at Boehringer Ingelheim. "Which is why we at Boehringer are delighted to support the American Heart Association on this critical initiative that will promote education and awareness, pinpoint new research areas and establish essential guidelines -; all critical areas of focus for us as a company, where we have rich history and knowledge."

The CKMH Initiative is part of the Association's strategic investment in improving care for CKM conditions. Four of the Association's Life's Essential 8TM -; weight, blood pressure, lipids and blood glucose -; are elements of metabolic dysfunction. When controlled, they lead to improved cardiovascular health, lowering the risk for heart disease, stroke, metabolic disorders, kidney disease and other major health problems. 

In January, the Association unveiled its  PREVENTTM (Predicting Risk of cardiovascular disease EVENTs) risk calculator, which incorporates CKM syndrome when evaluating heart attack, stroke and heart failure risk. The new initiative aims to increase systematic screening for social drivers of health and incorporate more community health workers and social workers into interdisciplinary care teams, among other efforts to combat negative social risk factors.

Due to the connections identified among these conditions, and as part of its second century vision for accelerating scientific breakthroughs, the American Heart Association in a separate endeavor will draw on its decades of experience to launch a novel patient-centric longitudinal registry of individuals living with obesity, including those prescribed treatment for weight management.

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