4 Evaluating Cardiovascular Disease (CVD) Risk Cardiovascular-kidney-metabolic (CKM) syndrome is a complex interplay among the cardiovascular system, metabolic risk factors and chronic kidney disease (CKD). The interaction of these risk factors affects nearly all organ systems and increases the risk for all subtypes of CVD, including stroke, coronary heart disease (CHD), heart failure (HF), atrial fibrillation (AFib), and peripheral artery disease (PAD). The greatest clinical consequence of the increased CVD risk in CKM syndrome is premature morbidity and mortality.2 Moreover, because of the interconnectedness of CKM syndrome, many patients have combinations of these conditions, with higher mortality rates as a result.2 Diabetes is linked to a 13- to 14-year-shorter life expectancy, with earlier onset conferring greater reductions in survival.2 Stage 4 CKD with an estimated glomerular filtration rate (eGFR) 15-29 mL/min/1.73m2 is associated with >20-yearshorter life expectancy, with death resulting from CVD being a major competing risk for the development of kidney failure requiring kidney replacement therapies.2 Grade III obesity, body mass index (BMI) 40 to <45 kg/m2, is associated with an estimated 8- to 10-year reduction in median survival.2 Cardiovascular Disease Metabolic Risk Factors Chronic Kidney Disease • Dyslipidemia • CKD • Subclinical/clinical CVD An estimated 90% of adults have at least one component of CKM syndrome,1 a newly defined condition that includes: • Overweight/obesity • Prediabetes • Type 2 diabetes • Hypertension
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