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Abstract
The American Heart Association Presidential Advisory 2023: cardiovascular-kidney-metabolic health overview provides guidance on the definition, staging, prognostic paradigm, and integrated approaches to care for patients with Cardiovascular-Kidney-Metabolic Syndrome (CKMS), and details a multicomponent vision for effective and equitable promotion of cardiovascular-kidney-metabolic health (CKMH) in the population. In addition, the document takes into account the social determinants of health in the models of care for CKMS and reduces the fragmentation of medical care, promotes the introduction of interdisciplinary approaches to patient-centred care. The main objective of the document is to create a framework for holistic and equitable improvement of the health of patients with CKMS worldwide. The first part of the review defines CKMS, describes the 10 key guidelines of the Presidential Advisory on cardiovascular-kidney-metabolic health, and describes a new model that classifies CKMS by stage and the structure of the stages.
References
Rangaswami J, Bhalla V, Blair JEA, Chang TI, Costa S, Lentine KL, Lerma EV, Mezue K, Molitch M, Mullens W, et al. on behalf of the American Heart Association Council on the Kidney in Cardiovascular Disease and Council on Clinical Cardiology. Cardiorenal syndrome: classification, pathophysiology, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. Circulation. 2019; 139:e840-e878. doi: 10.1161/CIR.0000000000000664
Palsson R, Patel UD. Cardiovascular complications of diabetic kidney disease. Adv Chronic Kidney Dis. 2014;21:273-280. doi: 10.1053/j.ackd.2014.03.003
Khayyat-Kholghi M, Oparil S, Davis BR, Tereshchenko LG. Worsening kidney function is the major mechanism of heart failure in hypertension: the ALLHAT study. JACC Heart Fail. 2021;9:100-111. doi: 10.1016/j.jchf.2020.09.006
Malik S, Wong ND, Franklin SS, Kamath TV, L’Italien GJ, Pio JR, Williams GR. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults.Circulation. 2004;110:1245-1250. doi: 10.1161/01.CIR.0000140677.20606.0E
Powell-Wiley TM, Poirier P, Burke LE, Després J-P, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, et al; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and cardiovascular disease: a scientific statement from the American Heart Association.Circulation. 2021;143:e984-e1010. doi: 10.1161/CIR.0000000000000973
Packer M. Critical reanalysis of the mechanisms underlying the cardiorenal benefits of SGLT2 inhibitors and reaffirmation of the nutrient deprivation signaling/autophagy hypothesis. Circulation. 2022;146:1383-1405. doi: 10.1161/CIRCULATIONAHA.122.061732
Joseph JJ, Deedwania P, Acharya T, Aguilar D, Bhatt DL, Chyun DA, Di Palo KE, Golden SH, Sperling LS; on behalf of the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; and Council on Hypertension. Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: a scientific statement from the American Heart Association.Circulation. 2022;145:e722-e759. doi: 10.1161/CIR.0000000000001040
Marx N, Husain M, Lehrke M, Verma S, Sattar N. GLP-1 receptor agonists for the reduction of atherosclerotic cardiovascular risk in patients with type 2 diabetes. Circulation. 2022;146:1882-1894. doi: 10.1161/CIRCULATIONAHA.122.059595
Remuzzi G, Perico N, Macia M, Ruggenenti P. The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease. Kidney Int Suppl. 2005:S57-S65. doi: 10.1111/j.1523-1755.2005.09911.x
Brewster UC, Setaro JF, Perazella MA. The renin-angiotensin-aldosterone system: cardiorenal effects and implications for renal and cardiovascular disease states. Am J Med Sci. 2003; 326:15-24. doi: 10.1097/00000441-200307000-00003
Cheng J, Zhang W, Zhang X, Han F, Li X, He X, Li Q, Chen J. Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on all-cause mortality, cardiovascular deaths, and cardiovascular events in patients with diabetes mellitus: a meta-analysis. JAMA Intern Med. 2014;174:773-785. doi: 10.1001/jamainternmed.2014.348
Larque E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, Pietrobelli A, Widhalm K. From conception to infancy: early risk factors for childhood obesity. Nat Rev Endocrinol. 2019;15:456-478. doi: 10.1038/s41574-019-0219-1
Brown CL, Halvorson EE, Cohen GM, Lazorick S, Skelton JA. Addressing childhood obesity: opportunities for prevention. Pediatr Clin North Am. 2015; 62:1241-1261. doi: 10.1016/j.pcl.2015.05.013
Longo M, Zatterale F, Naderi J, Parrillo L, Formisano P, Raciti GA, Beguinot F, Miele C. Adipose tissue dysfunction as determinant of obesityassociated metabolic complications. Int J Mol Sci. 2019;20:2358. doi: 10.3390/ijms20092358
Diaz-Santana MV, O’Brien KM, Park YM, Sandler DP, Weinberg CR. Persistence of risk for type 2 diabetes after gestational diabetes mellitus. Diabetes Care. 2022; 45:864-870. doi: 10.2337/dc21-1430