TY - JOUR
T1 - Cardiovascular-Kidney-Metabolic Health
T2 - A Presidential Advisory from the American Heart Association
AU - Ndumele, Chiadi E.
AU - Rangaswami, Janani
AU - Chow, Sheryl L.
AU - Neeland, Ian J.
AU - Tuttle, Katherine R.
AU - Khan, Sadiya S.
AU - Coresh, Josef
AU - Mathew, Roy O.
AU - Baker-Smith, Carissa M.
AU - Carnethon, Mercedes R.
AU - Despres, Jean Pierre
AU - Ho, Jennifer E.
AU - Joseph, Joshua J.
AU - Kernan, Walter N.
AU - Khera, Amit
AU - Kosiborod, Mikhail N.
AU - Lekavich, Carolyn L.
AU - Lewis, Eldrin F.
AU - Lo, Kevin B.
AU - Ozkan, Bige
AU - Palaniappan, Latha P.
AU - Patel, Sonali S.
AU - Pencina, Michael J.
AU - Powell-Wiley, Tiffany M.
AU - Sperling, Laurence S.
AU - Virani, Salim S.
AU - Wright, Jackson T.
AU - Rajgopal Singh, Radhika
AU - Elkind, Mitchell S.V.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/11/14
Y1 - 2023/11/14
N2 - Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
AB - Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
KW - AHA Scientific Statements
KW - chronic kidney disease
KW - diabetes
KW - metabolic syndrome
KW - obesity
KW - risk prediction
KW - social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85176972747&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85176972747&partnerID=8YFLogxK
U2 - 10.1161/CIR.0000000000001184
DO - 10.1161/CIR.0000000000001184
M3 - Review article
C2 - 37807924
AN - SCOPUS:85176972747
SN - 0009-7322
VL - 148
SP - 1606
EP - 1635
JO - Circulation
JF - Circulation
IS - 20
ER -