Approximately 90% of U.S. adults are at risk for Cardiovascular-Kidney-Metabolic (CKM) syndrome, yet a recent American Heart Association survey reveals that nearly 90% of the public has never heard of the condition. The syndrome, which reflects how heart disease, kidney disease, diabetes, and obesity influence or worsen each other, was defined by the American Heart Association (AHA) for the first time in October 2023. The organization, which describes itself as a "relentless force changing the future of health for everyone everywhere," is now working to ensure the public understands that these conditions are closely linked.
Understanding the Interconnected Nature of CKM Syndrome
Cardiovascular-kidney-metabolic syndrome characterizes how heart disease, kidney disease, diabetes, and obesity influence and worsen one another over time. While these health conditions were previously considered separate problems and are often managed separately, the AHA now emphasizes that they are interconnected. According to the association, the interplay of these risk factors increases the risk for heart attack, stroke, and heart failure more than any one of them alone. CKM health specifically involves the heart, the kidneys, and the metabolic system—which is responsible for creating, using, and storing energy, thereby affecting weight and blood glucose levels. When one of these systems functions poorly, it can negatively impact the others, creating a cycle that places an individual’s health at serious risk.
To diagnose CKM syndrome, healthcare providers test various risk factors to determine a patient’s stage on a scale from 0 to 4. Stage 0 means no risk factors are present, while Stage 1 is defined by excess body fat. Stage 2 involves a condition such as Type 2 diabetes, high blood pressure, or kidney disease. Stage 3 represents heart disease without symptoms or a high risk of developing it. Finally, Stage 4 signifies heart disease with symptoms, extra body fat, and risk factors for diabetes or other metabolic conditions, which could also include kidney disease.
Survey Findings on Public Awareness and Knowledge Gaps
In August 2025, The Harris Poll conducted a survey of approximately 4,000 U.S. adults on behalf of the American Heart Association to gauge public awareness of CKM syndrome and CKM health. The results, released on October 20, 2025, highlighted a significant knowledge gap: only 12% of U.S. adults had heard of CKM health or CKM syndrome. Furthermore, 68% of U.S. adults incorrectly believe it is best to manage individual conditions one at a time or are unsure of the best way to manage them. Additionally, 42% of those surveyed believed that a healthy heart would not likely be damaged by other organ systems or were unsure.
Despite the lack of familiarity, there is a clear interest in learning more. Approximately 79% of respondents agreed that it is important to understand more about CKM health, and 72% expressed an interest in learning more about the condition. Specifically, people are most interested in learning about how CKM syndrome is diagnosed (71%) and treated (72%).
"We want people to know that it’s really common to have heart, kidney and metabolic risk factors at the same time. It is reassuring that once the CKM connection was defined nearly three-quarters of those responding understood that it was important and wanted to learn more," said Eduardo Sanchez, M.D., FAHA, the American Heart Association’s chief medical officer for prevention.
Collaborative Care and Future Clinical Guidelines
The American Heart Association is aiming for a future where patients receive holistic treatment for CKM syndrome rather than treatment for one body system at a time. Through its CKM Health Initiative™, the association is providing a website and educational resources to help people understand how heart, kidney, and metabolic health are connected. The initiative is made possible by Founding Sponsors Novo Nordisk® and Boehringer Ingelheim, Supporting Sponsors Novartis Pharmaceuticals Corporation and Bayer, and Champion Sponsor DaVita®.
The association is also working with healthcare teams across the country to improve collaboration among professionals who care for patients living with multiple health conditions. For most individuals, CKM syndrome is reversible with changes to eating patterns, physical activity, and appropriate treatment. The association plans to issue its first-ever clinical guidelines focused on CKM syndrome in early 2026.
"The heart, kidney and metabolic systems are connected and, as such, should be treated in a coordinated way," Sanchez said. "These results reveal the need to emphasize those connections and help patients understand the importance of collaborative care."
Risk Factors and Prevention Strategies
According to a study published in JAMA, nearly 90% of U.S. adults have at least one risk factor for CKM syndrome, which include:
- High blood pressure
- Abnormal cholesterol
- High blood glucose (sugar)
- Excess weight
- Reduced kidney function
To help the public visualize these connections, the American Heart Association released educational materials clarifying the "2 truths" of heart health. This includes the following sequence: the heart pumps blood to the body; the metabolic system turns glucose from the blood into energy; the process of metabolism dumps waste back into the blood; the kidneys filter waste from the blood and balance fluids, which helps with blood pressure; and finally, blood pressure affects how the heart pumps blood into the body. Sanchez noted that "CKM health is about your overall health," adding, "You can take care of your overall health with regular checks of your blood pressure, cholesterol, weight, blood sugar and kidney function."
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