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 staging framework and the Association’s PREVENT equations, according to preliminary research to be presented at the Association’s Scientific Sessions 2026.
The survey, a baseline assessment of sites that have joined the Association’s CKM Health Initiative, included 97 clinical sites that completed a standardized questionnaire between August 2025 and June 2026. The initiative, launched in 2025, is a learning collaborative and quality improvement initiative focused on adopting a CKM-coordinated care model in about 150 clinical sites across the U.S. The findings underscore a gap between routine screening and the use of more comprehensive assessment tools that could better identify patients at high risk.
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.
Key findings show that 75% of clinical sites screened for CKM-related conditions, 73% systematically tested patient populations for CKM risk factors, but only 28% used the PREVENT equations to estimate cardiovascular disease risk and only 22% used CKM syndrome staging. Additionally, only 22% of sites reported measuring patients’ waist circumference as standard practice.
“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.”
Ndumele said the CKM syndrome staging 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.
“We see these conditions that define CKM syndrome clustering together – if a person has one condition, they’re more likely to be at risk for the others. Because they are so closely interconnected, we need to look at these all together, which led to this initiative,” Ndumele said. “The baseline assessments highlight areas most requiring targeted focus of implementation efforts to improve CKM syndrome care. Additionally, the details from this analysis inform the blueprint for adoption of evidence-based standards and a CKM model of care and provide evidence to support implementation. These findings could also pave the way for other healthcare sites and hospital systems seeking to improve care for patients with CKM syndrome within their clinical population.”
Study limitations include that data from only 97 of the 150 initiative sites were available at the time of analysis, and the survey represents self-reported data subject to recall bias and potential misclassification. Clinical sites were selected by the initiative, which is subject to selection bias. Ongoing assessments will provide a more comprehensive understanding of the implementation of CKM syndrome practices, as well as related barriers and opportunities, researchers said.
The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. The research is being presented at the American Heart Association’s Scientific Sessions 2026, a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science. The meeting is scheduled for Nov. 6-9 in Chicago.
