By Heather O’Donnell
For the first time, the American Heart Association identified a new medical condition called cardiovascular-kidney-metabolic syndrome (CKM), which emphasizes the strong connections between cardiovascular disease, chronic kidney disease, Type 2 diabetes, and obesity (AHA, 2023). The relationship between these conditions is an example of the ways the organs in the body are connected (CDC, 2022). Individuals with cardiovascular disease experience an increased risk of developing kidney disease, type 2 diabetes, or obesity. The opposite is also true–patients with any of these three conditions experience an increased risk of developing cardiovascular disease (Walter, 2023).
CKM ranges from zero, the lowest-risk stage with no risk factors and a preventive focus, to four, the highest-risk stage with cardiovascular disease and kidney disease symptoms and complications (AHA, 2023; Schaffer, 2023). It affects almost every organ in the body, including the brain, heart, kidney, and liver (Ndumele et al., 2023). About one in three American adults have three or more risk factors that contribute to kidney disease, cardiovascular disease, and diabetes (Tsao et al., 2023). A better understanding of CKM will improve chronic disease prevention, screening, diagnosis, and treatment in New Jersey through more integrated care.
In 2021, the percentages of adults in New Jersey who reported having chronic kidney disease, cardiovascular disease, diabetes, and obesity were 2.7%, 7.3%, 20.3%, and 28.2%, respectively (America’s Health Rankings, 2023). Chronic diseases are the leading causes of death and disability in the United States and New Jersey (CDC, 2022). They will cost New Jersey $53.7 billion in medical costs and $21.9 billion in lost employee productivity per year between 2016 and 2030, and the projected total cost is $1.1 trillion (Partnership to Fight Chronic Disease). These physical and financial effects make it important to develop effective prevention strategies that draw upon the interconnectedness between many chronic diseases.
Research shows that about one-third of people with diabetes have kidney disease (CDC, 2022), and high blood pressure and high blood sugar can cause and worsen kidney damage and increase the risk for heart attack and stroke, and diabetes can damage blood vessels in the kidney, leading to chronic kidney disease and kidney failure (AHA and ADA, 2022). Chronic kidney disease increases the risk for heart attack and stroke by preventing the kidneys from filtering blood as well as they should, causing an excess of fluid and waste from the blood to remain in the body (CDC, 2022). Due to these biological links, chronic kidney disease, cardiovascular disease, obesity, and diabetes share similar risk factors that should be monitored, including high blood sugar, high blood pressure, unhealthy diet, physical inactivity, tobacco smoking, excessive alcohol consumption, and inadequate sleep patterns (CDC, 2022). Obesity is also a risk factor for Type 2 diabetes, cardiovascular disease, and chronic kidney disease (NIH, 2023).
Although many chronic diseases are preventable, 25% of adults in New Jersey are considered physically inactive (CDC, 2022), 62% are overweight or obese, 34% eat less than one fruit a day, 21% eat less than one vegetable a day, and 16% smoke cigarettes (Partnership to Fight Chronic Disease). To manage and prevent all four conditions at once, individuals can engage in regular physical activity, eat a healthy diet, achieve and maintain a healthy weight, quit or avoid smoking, limit alcohol consumption, maintain healthy blood sugar and blood pressure levels, and attend regular preventive medical appointments (CDC, 2022).
There are several programs in New Jersey that have been developed to help individuals prevent and manage chronic diseases by making healthy lifestyle choices. The New Jersey Heart Disease and Stroke Prevention Program establishes policies to improve the prevention and management of heart disease and stroke in New Jersey (NJ Department of Health, 2023). The New Jersey Diabetes Prevention and Control Program aims to improve patient participation in diabetes self-management and prevention programs (NJ Department of Health, 2023). The Kidney Disease Prevention and Education Task Force aims to establish a cost-effective plan for the early screening, diagnosis, and treatment of chronic kidney disease (State of New Jersey Senate 220th Legislature, 2022).
The Regional Chronic Disease Coalition of Middlesex and Union Counties aims to implement strategies that support and reinforce healthful behaviors and reduce the risk for multiple diseases simultaneously through awareness, outreach, and education (Middlesex County NJ, 2023). In recent years, it has implemented heart health and nutrition awareness programs, advocated for smoke-free parks and recreation areas, and promoted the screening and early detection of kidney disease, cardiovascular disease, and diabetes (Middlesex County NJ, 2023). These programs will allow New Jerseyans to lead healthier lifestyles and achieve optimal cardiovascular, metabolic, and kidney health.
Heather O’Donnell is a recent graduate of the Bloustein School of Planning and Public Policy, having earned a bachelor of science degree in Public Health.
References:
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