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A new study suggests that people with chronic kidney disease, type 2 diabetes, or both conditions may face an increased risk of cardiovascular disease 8 to 28 years earlier than people without these conditions.
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Chronic kidney disease and type 2 diabetes are components of the cardiovascular-renal-metabolic (CKM) syndrome, which significantly affects the risk of cardiovascular disease.
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These results may help medical professionals diagnose CVD in their patients earlier and help prevent disease.
A study recently presented at the 2024 American Heart Association Scientific Sessions suggests that people with chronic kidney disease, type 2 diabetes, or both may face an increased risk of cardiovascular disease 8 to 28 years earlier than people without these conditions.
Researchers used simulated patient profiles to determine how risk factors associated with CKM syndrome interact with age.
Although these results have yet to be published in a peer-reviewed journal, they may inform previous detection and intervention strategies in cardiovascular disease prevention.
Both chronic kidney disease And type 2 diabetes increase this risk and are part of the four elements of the cardiovascular-renal-metabolic (CKM) syndrome.
Current guidelines for the prevention of cardiovascular disease consider the risk to be increased if there is a 7.5% or greater chance of: heart attack or myocardial infarction within the next decade.
The American Heart Association defines CKM syndrome as the link between cardiovascular disease, kidney disease and metabolic disorders such as type 2 diabetes obesity.
The study aimed to understand the impact of CKM syndrome on cardiovascular disease risk.
Developing cardiovascular risk profiles
Researchers developed risk profiles for men and women between the ages of 30 and 79 years, with and without chronic kidney disease and/or type 2 diabetes.
They used the one from the American Heart Association Calculator for predicting the risk of cardiovascular disease EVENTs (PREVENT). to estimate the age at which each profile was likely to reach increased CVD risk. Data from the risk profiles were used for the risk profiles National Health and Nutrition Examination Survey from 2011 to 2020.
Chronic kidney disease was classified using an estimated glomerular filtration rate (eGFR) of 44.5, indicating stage 3 kidney disease.
Type 2 diabetes was identified by a “yes” response to the PREVENT calculator question: “Any history of diabetes.”
The American Heart Association notes that nearly half of all American adults have some form of cardiovascular disease (CVD). one in three has at least three risk factors associated with CKM syndrome.
Identifying those at highest risk earlier can improve primary prevention efforts and reduce the risk of premature death from cardiovascular disease.
Lead study author Vaishnavi Krishnan, B.Sa researcher at Northwestern University in Chicago and a medical student at Boston University School of Medicine in Boston explained the key findings to Medical news today.
“Our research shows that the risk of cardiovascular disease varies significantly depending on a person’s age and other health conditions. In particular, individuals with diabetes or kidney disease are at a much higher risk of heart disease, even at a very young age in their 30s – which is now possible to calculate with the PREVENT equations.”
– Vaishnavi Krishnan, lead author
“This could not previously be assessed with the Pooled Cohort Equations because it started at age 40 and did not take into account renal function,” explains Krishnan.
She added that the study “should help better understand the risk of cardiovascular disease, including heart attack, heart failure and stroke.”
Borderline levels and CKM conditions can increase cardiovascular risk
People with borderline high blood pressure, glucose or kidney function may face hidden health risks even without a formal diagnosis.
These risks are more likely to occur in people with CKM (Cardiovascular-Kidney-Metabolic) conditions such as kidney disease or diabetes.
For example, while increased cardiovascular risk begins around age 68 for women and 63 for men without CKM, it can occur decades earlier for people with CKM, especially in combined conditions.
New AHA initiative to improve heart health monitoring
To address these risks, the American Heart Association has created a four-year initiative to improve CKM care.
By promoting collaboration between organizations and identifying gaps in clinical care, it is hoped that clearer, evidence-based treatment guidelines can be developed.
Richard Wright, MDsaid a board-certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, not involved in the study MNT that “this interesting and provocative analysis is merely a simulation and not based on actual clinical data, but nevertheless dramatically points to the potential “more than additive” risk that these conditions pose in predicting future cardiovascular events.”
“While not as scientifically sound as an actual prospective population study, the current assessment is based on valid science and should not be ignored,” he said. Medical news today.
“It has been known for decades that type 2 diabetes mellitus is an important predictor of early atherosclerotic and cardiac events. More recently, the additional risk posed by the presence of chronic kidney disease, manifested by reduced creatinine clearance, the presence of albumin in the urine, or both, has been recognized. Both conditions potentiate the initiation and progression of atherosclerosis and multiple other cardiovascular pathologies through different pathways, including through an increase in systemic inflammation.”
–Richard Wright, MD
“Even astute physicians will likely be surprised by the sobering prediction that the coexistence of these two problems radically increases the risk of early myocardial infarction and stroke,” Wright explains.
“This is truly a call to action, both to identify those at such risk and to begin more aggressive treatment earlier than we have traditionally thought necessary,” he added.
Conditions such as diabetes increase cardiovascular risk
Cheng-Han Chen, MDa board-certified interventional cardiologist and medical director of the Structural Heart Program at Memorial Care Saddleback Medical Center in Laguna Hills, CA, also not involved in the study, said that “a simulated risk study can be a useful tool to evaluate the utility of our risk models and provide information on how a risk model can be better adapted and corrected for clinical use.”
“Type 2 diabetes leads to high blood sugar levels that damage the blood vessels in our body. This then results in atherosclerosis, which can then lead to conditions such as heart attack and stroke. Likewise, chronic kidney disease can have effects such as increased blood pressure, atherosclerosis and inflammation, all of which can increase the risk of cardiovascular disease.”
– Cheng-Han Chen, MD
Dr. Chen added that “the AHA’s initiative on Cardiovascular-Renal-Metabolic Syndrome is an important framework for us to approach the prevention and management of these common and interconnected diseases.”
“By considering these conditions together, we may be able to design better treatments to help improve health outcomes.”
View the original article at Medical news today