The Hidden Health Crisis: The "Invisible Threat" Faced by 281 Million People in America

The Hidden Health Crisis: The "Invisible Threat" Faced by 281 Million People in America

1｜The Paradox of "Unknown Yet Almost Everyone is Affected"

The U.S. general media outlet 'The Independent' reported on October 21 (local time) about a concept called Cardiovascular-Kidney-Metabolic (CKM) Syndrome, which views the heart, kidneys, and metabolism (such as obesity and glucose metabolism disorders) as interconnected. According to a survey by the AHA (American Heart Association), 88% of respondents are unaware of CKM, while the majority of American adults have some risk factors. The article highlighted the gap between the disease's name recognition and its actual impact, stating that **"over 240 million people have at least one risk factor". Furthermore, it noted that one in three people has "three or more" risk factors**. The Independent


2｜What is CKM: From Organ-Specific Medicine to "Connected" Medicine

CKM is a concept that manages the overlap of heart disease, kidney disease, diabetes, and obesity as a whole. In 2023, the AHA presented its definition, stages, and intervention methods as a Presidential Advisory, proposing a direction to redesign healthcare that is often fragmented by organ into a "transversal" approach. This aims to stop the domino effect where kidney disease increases the risk of heart disease, diabetes and hypertension lead to kidney function decline, and ultimately result in heart failure or stroke. AHA Journals


3｜The "Silent Pandemic" in Numbers

  • Low Awareness: In an online survey conducted by the AHA in August (approximately 4,000 participants), 88% responded that they were unaware of CKM. **42%** believed or were unsure that "if the heart is healthy, other organs will not be affected." The Independent

  • Spread of Risk: The majority of American adults have one or more of the following: hypertension, abnormal lipids, high blood sugar, obesity, or decreased kidney function. Even among younger people, about 80% of those aged 20-44 have risk factors. The Independent

  • Publication Plan: The AHA plans to release the first CKM guidelines in early 2026. This has been reported by various media outlets. Yahoo News

These figures have been introduced on news sites and television. 'CBS News' and 'Newsweek' explain that "90% have never heard of it" and emphasize the "connection between heart, kidney, and metabolism." CBS News


4｜Hope in "Reversibility": 3 Out of 4 Can Be Reversed

AHA officials emphasize that **"3 out of 4 people can reverse the progression of CKM" through diet, exercise, and appropriate treatment. This is not about flashy miracle drugs. The steady management of blood pressure, blood sugar, cholesterol, weight, and kidney function is the **shortest route to breaking the vicious cycle that spans multiple organs. The Independent


5｜How to Diagnose: The Key is in the "Set" of Tests

CKM is not something that can be diagnosed as "positive/negative" with a single blood test. 'The Independent' introduces that the stage is determined by combining blood pressure, blood sugar, kidney function (eGFR and urine albumin), BMI, and coronary artery calcification (CAC) assessment. The CKM approach is to judge based on the overall picture rather than looking at individual numbers alone. The Independent


6｜Who Should Be Cautious: Age, Race, and Social Factors

Elderly people and the Black community have a higher risk of severe conditions. Meanwhile, younger people are not in a "safe zone." Survey data showing that already 80% of those aged 20-44 have risk factors overturns the preconception that it is a "disease of middle age and beyond." The influence of socio-economic factors on healthcare-seeking behavior and living environments should not be overlooked. The Independent


7｜Reactions on Social Media: Support, Skepticism, and Pressure for "Implementation"

 


In the medical community, there are many posts welcoming CKM's cross-organ approach. For example, specialized communities advocating for heart-kidney bridges emphasize that "early and coordinated management is key to reducing risks such as HFpEF (heart failure with preserved ejection fraction)." Hashtags like #CKM and #CardioKidneyMetabolic are prevalent. X (formerly Twitter)


The International Society of Nephrology (ISN) is also promoting awareness of the new CKM framework on occasions like World Heart Day, and there is a strong atmosphere of viewing cardio-renal-metabolic as a "new norm." X (formerly Twitter)


On the other hand, from general users and some healthcare providers, there is skepticism about whether "new terminology is running ahead on its own" and "what specifically will change in primary care visits." The widespread media coverage has led to articles being shared on platforms like Facebook, with many posts expressing surprise at the fact that **"most people have never heard of it."** Media reports have led to articles being shared on platforms like Facebook, with many posts expressing surprise at the fact that **"most people have never heard of it."** Facebook


From academic journal accounts, there are also posts introducing new issues and reviews from AHA journals, creating an atmosphere of moving towards the **"implementation phase"** in both clinical and research settings. X (formerly Twitter)


8｜"What Happens Next": Timeline

  • October 2023: AHA formally defines CKM in a Presidential Advisory, presenting staging and algorithms. AHA Journals

  • 2024: AHA launches the CKM Health Initiative, a four-year plan crossing healthcare providers, patients, and communities. www.heart.org

  • August 2025: AHA conducts a general public survey, finding "88% unaware of CKM." American Heart Association

  • Early 2026 (Planned): Publication of the first CKM guidelines, marking the start of full-scale clinical implementation. Yahoo News


9｜How Will the Field Change: "Handshake" Between Primary Care and Specialists

The core of CKM is that primary care physicians (family doctors, internists) conduct initial cross-organ assessments, and if necessary, cardiology, nephrology, and endocrinology operate on a common map. Specifically,

  • incorporating kidney and metabolic indicators into the "standard set" of health checkups and outpatient visits (eGFR, urine albumin, HbA1c, etc.).

  • Visualizing atherosclerosis through CAC (coronary artery calcification), to clinically realize the risk.

  • Selecting drugs with cardio-renal protective evidence, such as SGLT2 inhibitors and GLP-1 receptor agonists, from an early stage according to the stage.

  • Supporting lifestyle improvements, including weight, sleep, and exercise, with consistent goals. If this flow becomes established, the shift can be made from "organ-specific follow-up treatment" to "preventing the vicious cycle at the entry point."


10｜"Self CKM Check" You Can Do Today (General Information)

  • Blood Pressure: Record home blood pressure on the upper arm.

  • Weight and Waist Circumference: Monitor trends in increase or decrease.

  • Blood Sugar##

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