The first-ever clinical guideline for cardiovascular-kidney-metabolic syndrome, or CKM syndrome, identifies excess weight, particularly in the abdomen, as a primary factor contributing to the condition, according to a June 9 announcement. The guideline seeks to raise awareness about how heart disease, kidney disease, and metabolic conditions such as diabetes and obesity are interconnected.
Nearly nine in ten adults in the United States have at least one of the conditions within CKM syndrome. These include high blood pressure, abnormal cholesterol or other lipids, high blood glucose levels, reduced kidney function, and excess weight. As obesity rates continue to rise nationally, the new guidance emphasizes supporting healthy weight management and encourages healthcare professionals to start prevention-focused conversations with patients about how managing weight now can help prevent future health problems.
"In terms of CKM health, weight is not just about a number on a scale—people with the same body weight can have very different health profiles," said Chiadi E. Ndumele, M.D., Ph.D., an American Heart Association volunteer and chair of the writing committee for the new guideline. "Rather, what's most important is how fat tissue affects your metabolic health. This includes how your body manages blood sugar levels and how fat is used and stored." The new CKM syndrome guideline replaces previous guidelines from 2013 for managing overweight and obesity.
Ambar Kulshreshtha, M.D., Ph.D., who contributed to writing the guideline as part of his work with the Heart Association's Council on Quality of Care and Outcomes Research, said, "Maintaining a healthy weight has long been seen as essential to heart health and preventing other chronic illness. However, doctors don't always raise the topic of weight unless a patient brings it up...the focus is on appearance rather than health." Kulshreshtha also described using analogies when explaining CKM syndrome: "Obesity causes inflammation...It can damage the pump which is like your heart. And it can damage filters like your kidneys." Ndumele added that early conversations along with "an increasing array of tools" could help reverse or prevent dangerous stages of CKM syndrome.
The guideline highlights proven strategies supporting healthy lifestyle practices as foundational for managing CKM syndrome while also outlining medications that benefit multiple body systems, including SGLT2 inhibitors and GLP-1 based therapies. Fatima Rodriguez, M.D., M.P.H., vice-chair of the writing committee, noted, "But people with CKM syndrome don't experience one condition at a time—it often all hits at once." She emphasized that team-based care treats patients holistically: "The idea is that patient care is a team effort...the patient is team captain." The document recommends using coordinators or navigators to facilitate communication among healthcare professionals involved in treating these interconnected conditions.
