Abstract MP35: Community Prevalence of the Cardiovascular-Kidney-Metabolic (CKM) Syndrome: The Dallas Heart Study

Abstract

Introduction: The recent AHA presidential advisory on Cardiovascular-Kidney-Metabolic Syndrome (CKM) proposed a novel staging scheme, but limited data exist regarding CKM stage prevalence in the community. Prior population-based studies have lacked subclinical imaging measures, and have not reported variability by age, gender, and race/ethnicity. Methods: We estimated the population prevalence of CKM stages in Dallas County, from among 2,817 participants in the population-sampled Dallas Heart Study who attended study Visit 1 (2000-2002). Participants underwent protocol measurement of body composition, lipids, fasting blood sugar, serum creatinine, NT-proBNP, hs-cTnT, urinary albumin and creatinine, coronary artery calcium by cardiac CT (CAC), and cardiac function and mass by cardiac MRI. These were used to operationalize the following CKM stages: 0 – no CKM risk factors; 1 – excess or dysfunctional adiposity (body mass index, waist circumference, and fasting blood glucose); 2 – metabolic risk factors (hypertriglyceridemia, hypertension, diabetes, metabolic syndrome) and chronic kidney disease; 3 – subclinical cardiovascular diseases (CAC, LV hypertrophy or dysfunction by cardiac MRI, elevated cardiac biomarkers (NT-proBNP or hs-cTnT), high AHA-PREVENT or KDIGO scores); 4 – prevalent cardiovascular diseases (coronary heart disease, heart failure, atrial fibrillation, stroke). We used sampling weights to estimate the prevalence of CKM stages in Dallas County in 2000-2002 overall and by age category (30-44, 45-59, 60-65 years), gender, and race/ethnicity. Results: Among the 2,817 participants with a mean age of 44±10 years, the sample weighted demographics were 50% women, 52% non-Hispanic White, 20% non-Hispanic Black, and 26% Hispanic race/ethnicity. Among Dallas County adults, only 10% were CKM Stage 0 (no risk factors). The weighted prevalence of CKM Stages 1 through 4 was 16%, 46%, 23%, and 5%, respectively ( Figure A) . CKM stage prevalence was similar between men and women, while CKM Stage 4 was more frequent among older individuals and among non-Hispanic Black compared with non-Hispanic White and Hispanic individuals ( Figure B ). Conclusion: The public health burden of CKM is substantial. Ninety percent of Dallas County residents in 2000-2002 had some form of CKM syndrome, nearly half demonstrated metabolic dysfunction (Stage 2), and nearly one-fourth had subclinical cardiovascular disease (Stage 3).