Survey finds gaps in use of cardiovascular-kidney-metabolic syndrome tools

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by American Heart Association

edited by Sadie Harley, reviewed by Andrew Zinin

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Clinical staging for cardiovascular-kidney-metabolic (CKM) syndrome. Credit: American Heart Association

In a survey of health clinics participating in a new initiative to improve care for cardiovascular-kidney-metabolic (CKM) syndrome, most sites reported conducting basic screening for heart, kidney and metabolic risks. However, far fewer are using newer guideline-recommended tools such as the CKM syndrome staging framework and the American Heart Association's PREVENT (Predicting Risk of cardiovascular EVENT) equations, according to new, preliminary research presented at the American Heart Association's Scientific Sessions 2026, held Nov. 6–9 in Chicago.

The American Heart Association defines cardiovascular-kidney-metabolic syndrome as a multisystem health disorder due to connections between obesity, type 2 diabetes, chronic kidney disease and heart disease. Nearly 90% of U.S. adults have at least one of the components of CKM syndrome, including high blood pressure, abnormal cholesterol, high blood glucose (sugar), excess weight, reduced kidney function or related heart conditions.

In 2025, the association launched a learning collaborative and quality improvement initiative focused on the adoption of a CKM-coordinated care model in about 150 clinical sites across the U.S. Participating sites in the initial launch were selected based on factors such as the burden of CKM syndrome in their community, structural and societal influences, rural location and health organization type.

All participating clinics were surveyed between August 2025 and June 2026 to document a baseline of the implementation status of the initiative recommendations. A total of 97 clinical sites completed the standardized questionnaire.

"We found that most of the sites were actively screening patients for CKM risk factors and related conditions. Far fewer were using specifically recommended clinical assessment tools such as CKM syndrome staging and the PREVENT equations," said lead author Chiadi Ndumele, M.D., Ph.D., M.H.S., FAHA, director of the Penn Center for Cardiometabolic Health and presidential professor of medicine at the University of Pennsylvania in Philadelphia.

"However, that isn't entirely surprising. These tools—and even CKM syndrome as a medical condition—embrace relatively new concepts just beginning to be adopted. This baseline is important because it shows we have an opportunity to improve patient care as we help clinicians understand how to better incorporate these tools into their practices."

Key findings:

  • 75% of clinical sites screened for CKM-related conditions;
  • 73% systematically tested patient populations for CKM risk factors;
  • Only 28% used the PREVENT equations to estimate cardiovascular disease risk; and
  • Only 22% used CKM syndrome staging.

"We see these conditions that define CKM syndrome clustering together—if a person has one condition, they're more likely to be at risk for the others. Because they are so closely interconnected, we need to look at these all together, which led to this initiative," Ndumele said.

"The baseline assessments highlight areas most requiring targeted focus of implementation efforts to improve CKM syndrome care. Additionally, the details from this analysis inform the blueprint for adoption of evidence-based standards and a CKM model of care and provide evidence to support implementation.

"These findings could also pave the way for other health care sites and hospital systems seeking to improve care for patients with CKM syndrome within their clinical population."

Ndumele said the CKM syndrome stages assessment and the PREVENT equations more closely identify specific risks and opportunities for improved care management.

There are four CKM syndrome stages, reflecting the typical evolution of CKM syndrome over time:

  1. Excess or dysfunctional fat, which may accumulate around the liver, pancreas, heart and kidneys.
  2. Chronic kidney disease and/or metabolic risk factors.
  3. Subclinical heart disease or high-risk equivalents.
  4. Clinical heart disease.

With early detection and preventive care to reduce progression of CKM syndrome stages, outcomes can improve substantially.

The American Heart Association's PREVENT equations, based on contemporary data from more than 6.5 million diverse U.S. adults, have improved accuracy and are more generalizable to the U.S. population than previous risk-prediction tools. They can estimate 10-year and 30-year risk for cardiovascular disease development for people ages 30–79 without known heart disease, thereby helping to inform the use of preventive therapies.

Study details, background, design and limitations:

  • After launching and onboarding novel assessments that screen for heart, kidney and metabolic risks, 97 clinical sites completed a standardized questionnaire to document their status and progress in implementing the new and improved screening and risk estimation tools.
  • Of the clinical sites, 92% identified as outpatient facilities with the highest representation in primary care; organization types were 44% safety net, 39% nonacademic and 16% academic.
  • Respondents reported which CKM-related screenings their clinics currently conduct: social drivers of health screenings (75%), screening for clinical CKM-related comorbidities (75%) and actively screening patient populations for CKM risk factors (73%) were the most performed.
  • Only 22% of sites reported measuring patients' waist circumference as standard practice.
  • Only 28% of sites reported cardiovascular disease risk estimation via the PREVENT equations, while only 22% reported use of CKM syndrome staging.

Study limitations include that although 150 clinical sites are included in the initiative, data from only 97 sites were available at the time of this analysis. The survey represents self-reported data from clinical sites, which are subject to recall bias and potential misclassification. Also, clinical sites were chosen by the initiative, which is subject to selection bias.

Ongoing assessments will provide a more comprehensive understanding of the implementation of CKM syndrome practices, as well as related barriers and opportunities, researchers said.

"We hope adoption of the newer, more comprehensive tools can help identify patients at higher risk and guide the effective provision of more whole-person care," Ndumele said.

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CardiologyNephrologyEndocrinologyCommon illnesses & PreventionPreventive medicineHealthy living Provided by American Heart Association Who's behind this story?

Sadie Harley

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Citation: Survey finds gaps in use of cardiovascular-kidney-metabolic syndrome tools (2026, November 2) retrieved 2 November 2026 from https://medicalxpress.com/news/2026-10-survey-gaps-cardiovascular-kidney-metabolic.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.