American Heart Association proposes adding kidney disease to heart risk

New York : The American Heart Association (AHA) on Monday for the first time proposed adding kidney disease as a risk factor for Cardiovascular Disease (CVD). Various aspects of CVD that overlap with kidney disease, Type 2 diabetes and obesity support the new approach.

The AHA in a presidential advisory, published in the journal Circulation, defined the overlap in these conditions as cardiovascular-kidney-metabolic (CKM) syndrome. People who have or are at risk for cardiovascular disease may have CKM syndrome.

The scientific statement brings together evidence from current guidelines and large research studies and describes where gaps remain in knowledge needed to further improve CKM health.

CKM affects nearly every major organ in the body, including the heart, brain, kidney and liver. However, the biggest impact is on the cardiovascular system, affecting blood vessels and heart muscle function, the rate of fatty buildup in arteries, electrical impulses in the heart and more.

“The advisory addresses the connections among these conditions with a particular focus on identifying people at early stages of CKM syndrome,” said Chiadi E. Ndumele, writing committee chair and an associate professor of medicine and director of obesity and cardiometabolic research in the division of cardiology at Johns Hopkins University in Baltimore.

“Screening for kidney and metabolic disease will help us start protective therapies earlier to most effectively prevent heart disease and best manage existing heart disease,” Ndumele said. CKM syndrome is a consequence of the historically high prevalence of obesity and Type 2 diabetes in both adults and youth, according to the advisory.

Type 2 diabetes and obesity are metabolic conditions -- the “M” in CKM -- that are also risk factors for cardiovascular disease. Moreover, the most common cause of death for people with Type 2 diabetes and chronic kidney disease is cardiovascular disease. “We now have several therapies that prevent both worsening kidney disease and heart disease,” Ndumele said.

“The advisory provides guidance for health care professionals about how and when to use those therapies, and for the medical community and general public about the best ways to prevent and manage CKM syndrome.” With multiple conditions to manage, Ndumele noted fragmented care is a concern in treating patients with CKM syndrome, particularly for those with barriers to care.

“The advisory suggests ways that professionals from different specialties can better work together as part of one unified team to treat the whole patient.” Additionally, the advisory emphasises the importance of systematically screening for and addressing social factors that act as determinants, or drivers, of health, such as nutrition insecurity and opportunities for exercise, as key aspects of optimal CKM syndrome care.”