Global Burden of the Key Components of Cardiovascular-Kidney-Metabolic Syndrome

Key Points Ischemic heart disease and stroke were the leading contributors to the cardiovascular-kidney-metabolic (CKM) syndrome–related burden in 2021. Regions with a middle sociodemographic index, such as Southeast Asia and the Western Pacific, faced the highest burden. The burden of CKM syndrome is substantial and projected to rise through 2046, highlighting the need for targeted interventions. Background Cardiovascular-kidney-metabolic (CKM) syndrome highlights the interconnected nature of metabolic diseases, CKD, and cardiovascular diseases, representing a significant and growing public health burden. This study aimed to quantify the global burden of CKM syndrome by examining its key components, including high body mass index, diabetes, CKD, atrial fibrillation and flutter, lower extremity peripheral arterial disease, ischemic heart disease, and stroke. Methods Data were derived from the Global Burden of Disease 2021 platform, which provided estimates for incidence, prevalence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs). A decomposition analysis was performed to assess the contributions of population growth, aging, and epidemiologic changes to the burden of CKM syndrome. A NORDPRED model was used to project future trends in DALYs, years of life lost, and years lived with disability through 2046. Results Globally, ischemic heart disease and stroke were the major contributors to the CKM syndrome–related burden in 2021. Regions with a middle sociodemographic index (SDI), such as Southeast Asia and the Western Pacific, experienced the largest burden. However, age-standardized DALY rates were inversely related to SDI, with regions of lower SDI exhibiting higher rates. From 1990 to 2021, DALYs for the seven key components of CKM syndrome increased, primarily driven by population growth and aging. However, age-standardized DALY rates varied across components, with stroke (−38.7% [95% uncertainty interval: −43.4% to −34.0%]), peripheral arterial disease (−30.1% [−33.5% to −27.2%]), and ischemic heart disease (−28.8% [−32.5% to −25.2%]) showing a declining trend, whereas diabetes (38.2% [29.7%–47.0%]) and high body mass index (25.5% [16.6%–33.7%]) exhibited an increasing trend. Further projection analysis suggested a consistent trend in the changes in CKM syndrome–related burden from 2022 to 2046, with increases ranging from 55.9% for stroke to 105.7% for atrial fibrillation and flutter. Conclusions The findings of this study highlight the substantial and growing CKM syndrome–related burden.