Most clinical sites participating in a new American Heart Association initiative to improve care for cardiovascular-kidney-metabolic (CKM) syndrome are conducting basic screening for heart, kidney and metabolic risks, but far fewer are using newer guideline-recommended tools such as the CKM syndrome staging framework and the Association's PREVENT equations, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2026.
The survey of 97 primary care and other outpatient facilities found that 75% screened for CKM-related conditions, 73% systematically tested patient populations for CKM risk factors, and 75% conducted social drivers of health screenings. However, only 28% used the PREVENT equations to estimate cardiovascular disease risk, and only 22% used CKM syndrome staging. The findings were released via NEWMEDIAWIRE.
The American Heart Association defines CKM syndrome as a multi-system health disorder due to connections between obesity, Type 2 diabetes, chronic kidney disease and heart disease. Nearly 90% of U.S. adults have at least one component of CKM syndrome, including high blood pressure, abnormal cholesterol, high blood glucose, excess weight, reduced kidney function or related heart conditions.
In 2025, the Association launched a learning collaborative and quality improvement initiative focused on adopting a CKM-coordinated care model in about 150 clinical sites across the U.S. Participating sites were selected based on factors such as community burden of CKM syndrome, structural and societal influences, rural location and health organization type. All participating clinics were surveyed between August 2025 and June 2026 to document a baseline of implementation status.
"We found that most of the sites were actively screening patients for CKM risk factors and related conditions. Far fewer were using specifically recommended clinical assessment tools such as CKM syndrome staging and the PREVENT equations," said lead author Chiadi Ndumele, M.D., Ph.D., M.H.S., FAHA, director of the Penn Center for Cardiometabolic Health and Presidential Professor of Medicine at the University of Pennsylvania in Philadelphia. "However, that isn't entirely surprising. These tools - and even CKM syndrome as a medical condition - embrace relatively new concepts just beginning to be adopted. This baseline is important because it shows we have opportunity to improve patient care as we help clinicians understand how to better incorporate these tools into their practices."
The CKM syndrome stages assessment and the PREVENT equations more closely identify specific risks and opportunities for improved care management. There are four CKM syndrome stages, reflecting the typical evolution of CKM syndrome over time: excess or dysfunctional fat; chronic kidney disease and/or metabolic risk factors; subclinical heart disease or high-risk equivalents; and clinical heart disease. With early detection and preventive care to reduce progression along CKM syndrome stages, outcomes can improve substantially.
The PREVENT equations, based on contemporary data from more than 6.5 million diverse U.S. adults, have improved accuracy and are more generalizable to the U.S. population than previous risk predicting tools. They can estimate 10-year and 30-year risk for cardiovascular disease development for people ages 30-79 without known heart disease, helping to inform the use of preventive therapies.
The survey also found that only 22% of sites reported measuring patients' waist circumference as standard practice. Study limitations include that data from only 97 of 150 clinical sites was available at the time of analysis, and the survey represents self-reported data subject to recall bias and potential misclassification. Clinical sites were chosen by the initiative, which is subject to selection bias.
"We hope adoption of the newer, more comprehensive tools can help identify patients at higher risk and guide the effective provision of more whole-person care," Ndumele said. The findings could pave the way for other healthcare sites and hospital systems seeking to improve care for patients with CKM syndrome within their clinical populations.
The research is an abstract presented at the American Heart Association's Scientific Sessions 2026, held Nov. 6-9 in Chicago. Abstracts presented at the Association's scientific meetings are not peer-reviewed and are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. The full abstract is available in the abstract listing, and the meeting schedule can be found in the Online Program Planner.
