Prevalence, Disparities, and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in US Adults, 2011-2018

Abstract

Background

Cardiovascular-kidney-metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized.

Methods

Data from adults who completed the National Health and Nutrition Examination Survey between 2011 and 2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for cardiovascular-kidney-metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages.

Results

Among 8474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 were associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1000 person-years.

Conclusion

Approximately 13% of adults were in advanced stages, which disproportionately affect non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies.