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Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association

2023· review· en· 1,653 citations· W4387439311 on OpenAlex· 10.1161/cir.0000000000001184

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Abstract

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.

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The record

Venue
Circulation
Topic
Diet and metabolism studies
Field
Medicine
Canadian institutions
Funders
Janssen PharmaceuticalsNational Heart, Lung, and Blood InstituteCenters for Disease Control and PreventionNational Institutes of HealthNational Center for Advancing Translational SciencesAgencja Badań MedycznychMcGill University Health CentreMcGill UniversityNational Institute of Neurological Disorders and StrokeNovo NordiskHealth Services Research and DevelopmentUniversity of WashingtonU.S. Department of Veterans AffairsPatient-Centered Outcomes Research InstituteAstraZenecaEli Lilly and CompanyEmory University
Keywords
MedicineKidney diseaseMetabolic syndromeIntensive care medicineDiseasePopulationSubspecialtyKidneyInternal medicineObesityEnvironmental healthPathology
Has abstract in OpenAlex
yes