Journal article
Association between cardiovascular-kidney-metabolic syndrome and risks of 14 age-related health outcomes in primary prevention older population
GeroScience
01/12/2026
DOI: 10.1007/s11357-025-02058-x
PMID: 41526597
Abstract
The American Heart Association (AHA) recently introduced a new clinical entity; the cardiovascular-kidney-metabolic syndrome (CKMS), to promote a multi-disciplinary approach for chronic disease management. This study aims to investigate the relationship between CKMS and major adverse outcomes in older populations in primary care.
This study utilized data from 18,367 community-dwelling individuals aged ≥ 65, free from prior cardiovascular disease (CVD). Participants were classified into four CKMS stages (stage 0-no CKMS risk factor to stage 3-high CKMS risk) at baseline based on the AHA definition. The association with 14 health outcomes was analysed using multivariable cause-specific hazard models. Additional stratifications were performed by social disadvantage, inflammation levels, and number of CKMS components within each stage to refine risk staging.
Over a median follow-up of 8.6 years, the prevalence of CKMS stages 0 to 3 was 2.8%, 8.2%, 52.6%, and 36.0%, respectively. Compared to stage 0, stage 3 associated with all-cause mortality (HR 1.31, 95%CI 1.01-1.69), CVD mortality (3.11, 1.46-6.60), incident total CVD events (2.78, 1.86-4.15), myocardial infarction (2.37, 1.21-4.62), stroke (2.75, 1.50-5.04), heart failure hospitalization (4.56, 1.45-14.37), atrial fibrillation (2.63, 1.61-4.29), cancer (1.31, 1.04-1.64), depression (1.20, 1.04-1.39), and physical disability (1.92, 1.20-3.08). Social disadvantage, high inflammation, and CKMS component count further amplified these associations. No linear trend was observed for cognitive outcomes and non-CVD cause-specific mortality.
This study is the first to establish relationships between CKMS and multiple age-related outcomes in older adults, providing critical insights for developing holistic approaches to primary care in the aged.
Details
- Title: Subtitle
- Association between cardiovascular-kidney-metabolic syndrome and risks of 14 age-related health outcomes in primary prevention older population
- Creators
- Zhen Zhou - Monash UniversityKevan R Polkinghorne - Monash UniversityAndrew M Tonkin - Monash UniversityRobyn L Woods - Monash UniversityAnping Cai - Guangdong Academy of Medical SciencesSophia Zoungas - Monash UniversityMichelle A Fravel - University of IowaMichael E Ernst - University of IowaChao Zhu - Monash UniversityMark Nelson - University of TasmaniaJohannes T Neumann - Monash UniversityKerry M Sheets - Division of Geriatric Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USARaj C Shah - Rush University Medical CenterSuzanne G Orchard - Monash UniversityAnne M Murray - Berman Center for Outcomes and Clinical ResearchZimu Wu - Monash UniversityRory Wolfe - Monash UniversitySwarna Vishwanath - Monash UniversityPeng Qiu - Shanghai Ninth People's HospitalJoanne Ryan - Monash University
- Resource Type
- Journal article
- Publication Details
- GeroScience
- DOI
- 10.1007/s11357-025-02058-x
- PMID
- 41526597
- NLM abbreviation
- Geroscience
- ISSN
- 2509-2723
- eISSN
- 2509-2723
- Publisher
- SPRINGER
- Language
- English
- Electronic publication date
- 01/12/2026
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9985121501502771
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