The American Heart Association and American College of Cardiology have released the first clinical practice guideline for cardiovascular-kidney-metabolic (CKM) syndrome—an interconnected group of conditions that significantly increase the risk of heart disease, kidney disease and Type 2 diabetes.
Nearly 90% of U.S. adults have at least one CKM risk factor, including excess weight, high blood pressure, abnormal cholesterol, elevated blood sugar or reduced kidney function. The new guideline introduces a four-stage framework to help clinicians assess risk and intervene earlier.
Stage 1 includes individuals with overweight, obesity or prediabetes. Stage 2 adds metabolic risk factors such as hypertension, abnormal lipids or kidney disease. Stage 3 identifies those with early, often asymptomatic cardiovascular disease or high predicted risk, while Stage 4 includes people with diagnosed cardiovascular conditions such as heart attack, stroke or heart failure.The guideline emphasizes early screening, coordinated care and prevention.
Risk assessment tools like the PREVENT equations now incorporate kidney and metabolic health to better estimate long-term cardiovascular risk. It also highlights the importance of addressing social factors such as food insecurity and housing instability.
Treatment recommendations focus on lifestyle changes—healthy eating, physical activity, weight management and control of blood pressure, blood sugar and cholesterol—supported by medications and, when appropriate, metabolic or bariatric surgery. Newer therapies, including GLP-1-based medications and SGLT2 inhibitors, are recommended for select patients.
Ultimately, the guideline underscores that these conditions are deeply connected—and that early action can prevent serious complications and improve long-term health outcomes
To read the full practice guideline, visit newsroom.heart.org/news/first-ever-guideline-on-cardiovascular-kidney-metabolic-syndrome-issued.