Abstract 4146486: Prevalence, Incidence, and Progression of Cardiovascular-Kidney-Metabolic Syndrome in a Diverse Nationwide Cohort

Introduction: Recent studies using cross-sectional survey data have suggested high prevalence of cardiovascular-metabolic-kidney syndrome in the United States. However, these studies are limited by their cross-sectional design and cannot estimate progression or incidence reliably. In this study, we use the longitudinal nature of the AllofUs cohort to estimate the incidence and observe the progression and impact of CKM syndrome stages within a diverse cohort. Research Aims: To understand the distribution and impact of various stages of CKM syndrome within a diverse population cohort over an extended period and identify risk factors for CKM progression. Methods/Approach: Utilizing data from the AllofUs Research platform, we conducted a longitudinal analysis of patients within the cohort. Prevalence was calculated annually, while incidence was estimated by identifying new diagnoses of CKM syndrome. The incidence rate was calculated as the number of new diagnoses over the number of people at risk of developing that stage, using a one-year look-back window. We defined CKM stages according to recent AHA criteria, and additionally created three additional stages, which we termed Stage 5 (CVD and CKD stage 3-5), Stage 6 (>=2 CVD and CKD stage 3-5), and Stage 7 CKM (>=2 CVD, CKD stage 3-5, and >= one metabolic risk factor). Results: Our analysis revealed that the prevalence of CKM syndrome increased over the study period. For instance, the prevalence of Stage 1 CKM syndrome increased from 64.7% in 2018 to 80.18% in 2021, while Stage 2 CKM syndrome rose from 84.5% in 2018 to 92.91% in 2021. The incidence of various CKM stages in 2021 are shown in Table 1. The prevalence of all CKM stages are shown in Figure 1. At the conference, we will present models of risk factors for progression of CKM over time. Conclusions: More than 9 in 10 participants in a large nationwide cohort had Stage 2 CKM and the annual incidence of CKM ranged from 12% for Stage 1 CKM to ~3% for stage 4 CKM.