Presentation (CTI)

OBJECTIVES: Cardiovascular-kidney-metabolic (CKM) syndrome is highly prevalent in the US and has significant impact on morbidity and mortality. It describes a complex interrelationship between obesity, cardiovascular disease (CVD), chronic kidney disease and metabolic diseases like hypertension. The objective of this study was to describe the changing prevalence of CKM comorbidities in the US.
METHODS: We extrapolated historic NHANES data (2006-2023), to estimate the US adult population living with one or more CKM comorbidities including: obesity, hypertension, dyslipidaemia, type 2 diabetes (T2D), CVD, or poor kidney health, and describe how the prevalence has varied. We estimated the population-level prevalence of each of 64 unique combinations of comorbidities.
RESULTS: Between 2006 and 2023 the population of US adults grew by 16.8% (214m to 250m), the average age increased from 45.6 to 47.8, and the average BMI increased from 28.4 to 29.5. Over the same period the prevalence of each CKM comorbidity grew at significantly faster rates than population growth (obesity by 34.5%; hypertension by 41.7%; dyslipidaemia by 93.9%; T2D by 75.9%; CVD by 30.5%; and poor kidney health by 57.6%). Moreover, the proportion of US adults with at least one CKM comorbidity grew from 51.9% in 2006 to 59.2% by 2023, and the proportion with at least two CKM comorbidities grew from 21.4% to 28.4% in the same period.
CONCLUSIONS: The number of adult patients living with obesity in the US has risen far faster than the population has grown. Crucially, the average patient has become both older and more comorbid, increasing the risk of complications, healthcare cost, and difficulties in providing treatment. As CKM comorbidities have compounding effects on healthcare resource usage, it is paramount that this trend be addressed.