Using the American heart association's new 'cardiovascular-kidney-metabolic syndrome' metrics to assess life expectancy in us adults: A life table analysis

Background: Cardiac, kidney, and metabolic diseases are associated with a short life expectancy. However, the potential impact of the cardiovascular-kidney-metabolic (CKM) syndrome, recently introduced by the American Heart Association (AHA), on life expectancy at different stages has not yet been described. Objective: This study aimed to evaluate the association between CKM syndrome and life expectancy among adults in the United States. Methods: 9043 participants (age≥20 years) were included in this study who participated in the National Health and Nutrition Examination Survey from 2007-2018. The life table method was used to estimate life expectancy at each CKM syndrome stage. The Arriaga decomposition method estimated cause-specific contribution to differences in life expectancy between stages 0-1 CKM syndrome and stage 4 CKM syndrome participants. Results: During a mean 6.8 years of follow-up, a total of 842 deaths occurred, of which 218 individuals died of cardiovascular disease (CVD). Estimated life expectancy at age 50 years was 37.5 (95 % CI, 34.7-40.4), 32.6 (95 % CI, 32-33.6), 27.1 (95 % CI, 26.4-28.1), and 25.1 (95 % CI, 24.2-26.1) for participants in stages 0-1, 2, 3, and 4 CKM syndrome, respectively. At age 50, 26.7 % of the life expectancy reduction in individuals with stage 4 CKM syndrome was attributable to the increased risk of CVD mortality compared to those with stage 0-1 CKM syndrome. Conclusion: The higher stage of CKM syndrome is associated with shorter life expectancy. Due to the enormous health damage caused by CKM syndrome, more effective prevention and treatment should be explored as a high public health priority.