Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association
Open accessAbstract
Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health. However, there is also a growing number of therapeutic options that favorably affect metabolic risk factors, kidney function, or both that also have cardioprotective effects. To improve cardiovascular-kidney-metabolic health and related outcomes in the population, there is a critical need for (1) more clarity on the definition of cardiovascular-kidney-metabolic syndrome; (2) an approach to cardiovascular-kidney-metabolic staging that promotes prevention across the life course; (3) prediction algorithms that include the exposures and outcomes most relevant to cardiovascular-kidney-metabolic health; and (4) strategies for the prevention and management of cardiovascular disease in relation to cardiovascular-kidney-metabolic health that reflect harmonization across major subspecialty guidelines and emerging scientific evidence. It is also critical to incorporate considerations of social determinants of health into care models for cardiovascular-kidney-metabolic syndrome and to reduce care fragmentation by facilitating approaches for patient-centered interdisciplinary care. This presidential advisory provides guidance on the definition, staging, prediction paradigms, and holistic approaches to care for patients with cardiovascular-kidney-metabolic syndrome and details a multicomponent vision for effectively and equitably enhancing cardiovascular-kidney-metabolic health in the population.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Data from MESA showed that CAC is strongly associated with a 10-year risk of incident ASCVD, independent of standard risk factors, and similarly across demographic groups.
“Data from MESA (Multi-Ethnic Study of Atherosclerosis)4 showed that CAC is strongly associated with a 10-year risk of incident ASCVD, independent of standard risk factors, and similarly across demographic groups.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The “Subclinical ASCVD” section (page unavailable) says CAC is associated with increased risk in the general population and in people with CKM risk factors. It does not state that MESA demonstrated a strong association with 10-year incident ASCVD independent of standard risk factors, or that the association was similar across demographic groups. The References section names MESA studies but does not establish those additional findings. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWhile a fasting lipid panel is preferred for dyslipidemia diagnosis, a nonfasting sample can also be used.
“While a fasting lipid panel is preferred for dyslipidemia diagnosis, a nonfasting sample can also be used.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
In “Assessments for CKM Risk Factors Among Adults” (page not supplied), the advisory says lipid measurements do not require fasting, supporting the use of a nonfasting sample. It does not say that a fasting lipid panel is preferred for dyslipidemia diagnosis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA nonjudgmental approach to initiating weight loss discussions increases the effectiveness of weight loss in adults with overweight or obesity receiving weight loss counseling.
“Among adults with overweight or obesity receiving weight loss counseling, a nonjudgmental approach to initiating weight loss discussions is recommended in order to increase the effectiveness of weight loss.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 CKM section recommends a patient-centered framework for weight-loss discussions, and Enhanced Obesity Management says established toolkits help clinicians initiate obesity discussions effectively. Neither passage specifies a nonjudgmental approach or says that it improves weight-loss outcomes among adults receiving counseling. Page numbers are not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLong-term weight management programs that emphasize increased physical activity help maintain lost weight in adults who have successfully lost weight.
“Among adults who have successfully lost weight, long-term weight management programs that, in part, emphasize increased physical activity should be recommended to maintain lost weight.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The “Obesity, MetS and CVD” section recommends regular physical activity and multidisciplinary support as part of weight-loss care. The “Enhanced Obesity Management” section also endorses support for weight management. Neither passage specifically addresses long-term programs for adults who have already lost weight or shows that such programs maintain the lost weight; page numbers were not available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredIn-person or virtual multicomponent behavioral interventions promote weight loss for CKM syndrome risk reduction in adults with overweight or obesity.
“Among adults with overweight or obesity, clinician referral to in-person or virtual multicomponent behavioral interventions is beneficial for promoting weight loss for CKM syndrome risk reduction.1,3,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 CKM section recommends lifestyle modification and multidisciplinary support for weight loss in people with obesity, and Enhanced Obesity Management endorses access to behavioral therapies. Our copy does not specifically recommend clinician referral to in-person or virtual multicomponent behavioral interventions, nor does it extend this recommendation explicitly to all adults with overweight. (LLM, conf=0.84)
Experimental — accuracy not yet measured
MBS can be beneficial to facilitate weight loss and mitigate CKM syndrome progression in patients with CKM stage 1 to 3 and obesity without adequate weight loss response to lifestyle modification.
“Among patients with CKM stage 1 to 3 and obesity without an adequate weight loss response to lifestyle modification, with or without the use of adjunctive obesity pharmacotherapies, MBS can be beneficial to facilitate weight loss and to mitigate CKM syndrome progression.1–8”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 CKM section presents bariatric surgery as an adjunct for people with BMI ≥40 kg/m² who do not meet weight-loss goals through lifestyle modification. The CKM Stage Regression section links substantial intentional weight loss to improvements across stages 1–3, but the advisory does not specifically recommend surgery for all patients with obesity in stages 1–3 or establish that surgery itself mitigates progression across those stages. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBoth SGLT2i and GLP-1-based therapy reduce major adverse cardiovascular events (MACE) and CVD mortality across multiple clinical trials.
“Both classes of agents reduce major adverse cardiovascular events (MACE) and CVD mortality across multiple clinical trials,39,40 with SGLT2i having a particular impact on HF hospitalizations and GLP-1–based therapy having a more substantial impact than SGLT2i on incident ASCVD events.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The “Diabetes and CVD” section (page unavailable) says that either an SGLT2 inhibitor or a GLP-1RA is advised to reduce MACE and cardiovascular mortality in patients with diabetes and ASCVD. The claim omits that population qualifier, and the cited passage does not establish that both outcomes were reduced across multiple clinical trials for each class. (LLM, conf=0.83)
Experimental — accuracy not yet measuredGLP-1-based therapy has a more substantial impact than SGLT2i on incident ASCVD events.
“Both classes of agents reduce major adverse cardiovascular events (MACE) and CVD mortality across multiple clinical trials,39,40 with SGLT2i having a particular impact on HF hospitalizations and GLP-1–based therapy having a more substantial impact than SGLT2i on incident ASCVD events.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
In “Potential to Guide Therapeutic Choices in At-Risk Populations” (page unavailable), the advisory says GLP-1RAs have demonstrated reduced ASCVD risk and may be prioritized when ASCVD risk exceeds HF risk. It does not establish that their impact on incident ASCVD events is greater than that of SGLT2 inhibitors; it says further comparative risk-reduction data are needed. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOf currently available agents, tirzepatide and semaglutide have the highest efficacy in terms of weight loss and metabolic benefits.
“Of the currently available agents, tirzepatide (dual GIP and GLP-1 RA) and semaglutide (GLP-1 RA) have the highest efficacy in terms of weight loss and metabolic benefits.4,5”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The “Obesity, MetS and CVD” section says incretin analogs should be prioritized because they produce marked weight loss and improve metabolic risk-factor control. It does not identify tirzepatide and semaglutide as the two most effective currently available agents or compare their efficacy with other agents; semaglutide appears in the name of a trial, not in such a ranking. No page number was provided for the passage. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLifestyle modification, including sodium reduction, weight loss, increased physical activity, and adherence to heart-healthy dietary patterns such as the DASH or Mediterranean diet, have shown benefit for reducing BP.
“Lifestyle modification, including sodium reduction, weight loss, increased physical activity, and adherence to heart-healthy dietary patterns such as the DASH or Mediterranean diet, have shown benefit for reducing BP.3,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
In “MetS, Hypertriglyceridemia, and Hypertension” (page unavailable), the advisory recommends lifestyle modification and a balanced low-sodium diet for hypertension management. It also cites a study titled “Exercise and weight loss reduce blood pressure” in its References (page unavailable). The copy does not identify DASH or Mediterranean diets or state that those specific dietary patterns reduce blood pressure. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThese meta-analyses show an attenuated benefit of RASi when compared with active controls of other antihypertensive agents, both for reducing the risk of CKD progression and for prevention of CVD.
“Of note, these meta-analyses show an attenuated benefit of RASi when compared with active controls of other antihypertensive agents, both for reducing the risk of CKD progression and for prevention of CVD.4,25”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The advisory’s CKM overview says RAAS inhibitors have cardiovascular and kidney benefits, and its Chronic Kidney Disease section recommends ACE inhibitors/ARBs as first-line treatment for hypertension with proteinuria (page unavailable). Neither passage reports the claimed meta-analytic comparison with other antihypertensive agents or says the benefits are attenuated against active controls. (LLM, conf=0.77)
Experimental — accuracy not yet measuredPersistently elevated triglycerides are considered a risk enhancer for ASCVD.
“Additionally, as per clinical guidelines, persistently elevated triglycerides are considered a risk enhancer for ASCVD.2,4–6”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
In “MetS, Hypertriglyceridemia, and Hypertension” (page unavailable), the advisory says hypertriglyceridemia increases ASCVD risk and advises statins for residual hypertriglyceridemia in people at intermediate or higher estimated risk. It explicitly calls metabolic syndrome—not persistently elevated triglycerides—an ASCVD risk enhancer, so the claim’s specific guideline classification is not established by this copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAmong patients with diabetes and albuminuric CKD in the FIDELITY pooled analyses, finerenone demonstrated a 21% reduction in HF (HR, 0.79 [95% CI, 0.66-0.92]), with similar benefits observed in those without a history of HF and in those with baseline LVH.
“Among patients with diabetes and albuminuric CKD in the FIDELITY pooled analyses, finerenone demonstrated a 21% reduction in HF (HR, 0.79 [95% CI, 0.66–0.92]),7 with similar benefits observed in those without a history of HF10 and in those with baseline LVH.39”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredStudies using relative-risk reduction estimates from RCTs and absolute event rates from epidemiologic studies of CAC demonstrate that moderate-to-severe CAC identifies patients at high absolute CVD risk who are most likely to benefit from several preventive therapies indicated for CKM syndrome (statins, GLP-1-based therapy, aggressive BP lowering, and icosapent ethyl in those with hypertriglycerid
“Studies using relative-risk reduction estimates from RCTs and absolute event rates from epidemiologic studies of CAC demonstrate that moderate-to-severe CAC identifies patients at high absolute CVD risk who are most likely to benefit from several preventive therapies indicated for CKM syndrome (statins, GLP-1–based therapy, aggressive BP lowering, and icosapent ethyl in those with hypertriglycerid”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredASCVD events increase risk for subsequent kidney failure.
“Having a bidirectional risk relationship, ASCVD events also increase risk for subsequent kidney failure.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The introductory discussion (section C; page unavailable) describes a bidirectional association between heart and kidney dysfunction, supporting the general direction of the claim. The Stage 4b CKM section discusses ASCVD in people who already have kidney failure, but the passages found do not establish that ASCVD events increase the risk of subsequent kidney failure. (LLM, conf=0.79)
Experimental — accuracy not yet measuredLifestyle interventions, such as a caloric-deficit diet and aerobic exercise training, have shown modest but clinically important improvements in weight and functional capacity among older adults with HFpEF.
“Lifestyle interventions, such as a caloric-deficit diet and aerobic exercise training, have shown modest but clinically important improvements in weight and functional capacity among older adults with HFpEF.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The “Obesity, MetS and CVD” section (page unavailable) recommends moderate intentional weight loss to improve functional status in patients with heart failure, initially through caloric restriction and regular physical activity. It does not specifically describe older adults with HFpEF, aerobic exercise training, or observed improvements in both weight and functional capacity. (LLM, conf=0.85)
Experimental — accuracy not yet measuredClinical trials demonstrate that quadruple therapy for HFrEF reduces cardiovascular mortality and HF hospitalizations within 30 days after starting treatment.
“Clinical trials demonstrate that these therapies reduce cardiovascular mortality and HF hospitalizations within 30 days after starting treatment, underscoring the importance of early intervention.3–5”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Subclinical HF section (page unavailable) says SGLT2 inhibitors reduce incident HF hospitalizations and cardiovascular mortality in patients with type 2 diabetes. The Obesity, MetS and CVD section mentions four pillars of HFrEF therapy, but the advisory does not report that quadruple therapy reduces both outcomes within 30 days of initiation. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn patients with HFpEF, obesity, and T2D, subcutaneous semaglutide significantly reduced body weight and improved KCCQ-CSS and 6MWD compared with placebo.
“Subcutaneous semaglutide significantly reduced body weight and improved KCCQ-CSS and 6MWD compared with placebo.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Obesity, MetS and CVD section says GLP-1–based therapies can produce substantial weight loss and mentions semaglutide in connection with a different cardiovascular trial (page unavailable). It does not report a placebo comparison in patients with HFpEF, obesity, and T2D, or improvements in KCCQ-CSS or 6MWD; searches for those outcomes found no supporting passage. (LLM, conf=0.81)
Experimental — accuracy not yet measuredThe addition of GLP-1-based therapy in the setting of T2D with obesity and HFpEF improves symptoms and functional capacity.
“The addition of GLP-1–based therapy in the setting of T2D with obesity and HFpEF improves symptoms and functional capacity.4,5”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Diabetes and CVD section says adding a GLP-1 receptor agonist to an SGLT2 inhibitor can be considered for patients with diabetes and heart failure who meet criteria including BMI ≥35 kg/m². It does not specify HFpEF or report that the addition improves symptoms or functional capacity; the nearby quality-of-life benefit is attributed to SGLT2 inhibitors, not GLP-1 therapy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAmong patients with HFrEF, RASi improves both HF outcomes and risk for worsening kidney disease in several clinical trials.
“Among patients with HFrEF, RASi improves both HF outcomes and risk for worsening kidney disease in several clinical trials.1–8,28”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The advisory’s “CKD and HF” section (page not supplied) prefers an angiotensin receptor/neprilysin inhibitor for HFrEF and associates its use with slower kidney-function decline and fewer adverse kidney events. It does not establish the same kidney benefit for RAS inhibitors as a class, nor does it state that several clinical trials showed improvements in both HF and kidney outcomes. (LLM, conf=0.83)
Experimental — accuracy not yet measuredCAC assessment improves prediction of ASCVD.
“CAC assessment improves prediction of ASCVD4,5 and selection of patients for treatment with aggressive ASCVD risk factor modification (ie, statin therapy).6”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
Assessments for prediabetes or diabetes with fasting blood glucose, HbA1c, or oral glucose tolerance tests are critical because of the strong association of hyperglycemia with cardiovascular and kidney disease.
“Assessments for prediabetes or diabetes with fasting blood glucose, HbA1c, or oral glucose tolerance tests are critical because of the strong association of hyperglycemia with cardiovascular and kidney disease.39,40”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
SGLT2i have a particular impact on HF hospitalizations.
“Both classes of agents reduce major adverse cardiovascular events (MACE) and CVD mortality across multiple clinical trials,39,40 with SGLT2i having a particular impact on HF hospitalizations and GLP-1–based therapy having a more substantial impact than SGLT2i on incident ASCVD events.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The management principles for CKM stage 2 carry over into CKM stage 3.
“The management principles for CKM stage 2 carry over into CKM stage 3.1,2,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
SGLT2i appear to primarily reduce incident and worsening HF.
“SGLT2i appear to primarily reduce incident and worsening HF.17,37–44”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
Data suggest that adults with prediabetes are also at risk for MASLD, and clinical endocrinology guidelines recognize prediabetes as a high-risk condition for MASLD.
“However, data suggest that adults with prediabetes are also at risk,4 and clinical endocrinology guidelines recognize prediabetes as a high-risk condition for MASLD.34”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
Chronic inflammatory or autoimmune conditions (eg, rheumatoid arthritis, SLE, HIV/AIDS) are risk enhancers for CKM syndrome.
“Chronic inflammatory or autoimmune conditions (eg, rheumatoid arthritis, SLE, HIV/AIDS)4,11”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
90% to 95% of US adults are in CKM stage 1 to 4.
“Unfortunately, 90% to 95% of US adults are in CKM stage 1 to 4, indicating an imperative to better facilitate the maintenance of ideal cardiovascular health starting early in life.2–4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The STAGING RATIONALE and Stage 0 sections define CKM stages and recommend maintaining ideal cardiovascular health from early life. Our copy does not give the proportion of US adults in stages 1–4; searches for the 90%–95% figure and stage prevalence found no supporting passage. (LLM, conf=0.72)
Experimental — accuracy not yet measuredGLP-1-based medications often cause gastrointestinal side effects, and their benefits reverse after discontinuation.
“Despite their benefits, these medications often cause gastrointestinal side effects, and their benefits reverse after discontinuation.1,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The advisory’s “Obesity, MetS and CVD” section describes weight-loss and cardiovascular benefits of GLP-1-based medications, but does not address the claimed gastrointestinal side effects or reversal of benefits after stopping them. Searches for gastrointestinal effects, nausea, weight regain, and discontinuation found no passage establishing either point; the passage mentioning discontinuation concerns other medications. (LLM, conf=0.76)
Experimental — accuracy not yet measuredWeight regain is a complex phenomenon that includes behavioral, physiological, and environmental factors.
“Weight regain is a complex phenomenon that includes behavioral, physiological, and environmental factors.39”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The Stage 1 CKM and Enhanced Obesity Management sections discuss lifestyle support, obesity treatment, and the pathophysiology of obesity, but not why weight returns after weight loss. Searches for “weight regain” and for behavioral, physiological, and environmental factors found no passage addressing the claimed causes of weight regain. Page numbers were not available in our copy. (LLM, conf=0.73)
Experimental — accuracy not yet measuredThe difference in average excess weight loss between RYGB and LSG persists at 10 years.
“Average excess weight loss is greater with RYGB (56%) than LSG (46%),2,18 with persistent differences at 10 years.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 CKM and Obesity, MetS and CVD sections discuss weight-loss goals and bariatric surgery, but do not compare RYGB with LSG or report excess weight loss at 10 years. Searches for both procedure names and for 10-year excess weight loss found no passage addressing the cited persistence claim; the percentages in the citing sentence are attached to other citations. (LLM, conf=0.74)
Experimental — accuracy not yet measuredBupropion/naltrexone use is associated with slight increases in BP.
“Additionally, bupropion/naltrexone use is associated with slight increases in BP.1,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Obesity, MetS and CVD section discusses obesity pharmacotherapy and blood-pressure management, but does not address whether bupropion/naltrexone raises BP. Searches for “bupropion,” “naltrexone,” and their combination with blood pressure found no passage making that claim; the available passages have no page numbers. (LLM, conf=0.76)
Experimental — accuracy not yet measuredHbA1c alone, whether assessed early or late postpartum, showed insufficient sensitivity for detecting abnormal glucose tolerance.
“HbA1c alone, whether assessed early or late postpartum, showed insufficient sensitivity for detecting abnormal glucose tolerance.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 and Stage 2 passages recommend screening for impaired glucose tolerance after gestational diabetes, but do not assess HbA1c as a postpartum test. Searches for early and late postpartum HbA1c sensitivity found no passage addressing whether HbA1c alone detects abnormal glucose tolerance adequately. (LLM, conf=0.72)
Experimental — accuracy not yet measuredA meta-analysis of primary and secondary CVD prevention trials demonstrated that a Mediterranean diet was associated with a 38% lower risk of CVD events.
“A meta-analysis of primary and secondary CVD prevention trials demonstrated that a Mediterranean diet was associated with a 38% lower risk of CVD events.4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The advisory’s Diabetes section recommends a healthy diet as part of lifestyle modification, but does not report the claimed Mediterranean-diet result. Searches for “Mediterranean,” “38%,” and a meta-analysis of primary and secondary prevention trials found no passage in our copy supporting the specific risk reduction. (LLM, conf=0.76)
Experimental — accuracy not yet measuredPrespecified analyses from a study of oral semaglutide showed that the observed benefits were independent of concomitant SGLT2i use (26.9% use at baseline, 48.9% use at any point during the trial).
“Finally, prespecified analyses from a study of oral semaglutide4 showed that the observed benefits were independent of concomitant SGT2i use (26.9% use at baseline, 48.9% use at any point during the trial).”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Diabetes and CVD section discusses GLP-1 receptor agonists and SGLT2 inhibitors, including possible dual use, but does not report a prespecified analysis of oral semaglutide. Searches for the stated SGLT2-inhibitor use percentages and for benefits independent of concomitant use found no matching passage in our copy; section page numbers were unavailable. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn the SECRET trial, peak oxygen consumption increased, and body weight decreased most in those receiving both calorie-restricted diet and supervised exercise, with slight reductions in lean mass in the diet arm.
“Peak oxygen consumption (VO2, mL/kg/min) increased, and body weight decreased most in those receiving both interventions, with slight reductions in lean mass in the diet arm.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The 'Obesity, MetS and CVD' section recommends moderate caloric restriction and regular physical activity, but does not report results from the SECRET trial. Searches for SECRET, peak oxygen consumption, and lean mass found no passage addressing the claimed changes or the comparison between intervention arms; page numbers were unavailable in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn adults with CKM syndrome stage 4 with CKD and symptomatic HFpEF, the cost-effectiveness of adding a SGLT2i prior to GDMT at 2025 US prices is indeterminate.
“In adults with CKM syndrome stage 4 syndrome with CKD and symptomatic HFpEF, the cost-effectiveness of adding a SGLT2i prior to GDMT at 2025 US prices is indeterminate.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The CKD and HF section recommends SGLT2 inhibitors for patients with both conditions regardless of ejection fraction, and Access to Pharmacotherapies discusses affordability. Neither section assesses the cost-effectiveness of adding an SGLT2 inhibitor before GDMT at 2025 US prices; searches for cost-effectiveness and that pricing scenario found no such assessment in our copy. Page numbers were not available. (LLM, conf=0.77)
Experimental — accuracy not yet measuredIn 2 high-quality simulation model-based cost-effectiveness analyses, addition of SGLT2i therapy to GDMT in adults with symptomatic HFpEF was projected to be not cost-effective, but the incremental cost-effectiveness ratio was sensitive to the effect on mortality.
“In 2 high-quality simulation model–based cost-effectiveness analyses that evaluated the economic value of adding SGLT2i therapy to prior GDMT in adults with symptomatic HFpEF using a US health care sector perspective and a lifetime analytic horizon, addition of SGLT2i therapy to GDMT was projected to be not cost-effective, but the incremental cost-effectiveness ratio was sensitive to the effect on”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAmong CKM syndrome patients with hypertriglyceridemia, non-HDLC or apolipoprotein B are more reliable measures of atherogenic particle burden than LDL-C.
“Among CKM syndrome patients with hypertriglyceridemia, non–HDLC or apolipoprotein B should also be considered as more reliable measures of atherogenic particle burden than LDL-C in this subpopulation.3,4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The advisory’s “MetS, Hypertriglyceridemia, and Hypertension” section discusses cardiovascular risk and treatment for hypertriglyceridemia, but not which lipid measure best reflects atherogenic particle burden. Searches for apolipoprotein B, non-HDL cholesterol, and comparisons with LDL-C found no passage addressing the claimed measurement comparison. Page numbers were not available in our copy. (LLM, conf=0.73)
Experimental — accuracy not yet measuredThese analyses pooled individuals without and with CKD and did not directly incorporate the benefit of SGLT2i therapy on kidney outcomes.
“However, these analyses pooled individuals without, and with, CKD and did not directly incorporate the benefit of SGLT2i therapy on kidney outcomes.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The Chronic Kidney Disease section says SGLT2 inhibitors protect kidney function, and the risk-prediction section discusses limitations of existing equations. Neither says that the analyses in question pooled people with and without CKD or omitted SGLT2i kidney benefits. Searches for pooled analyses and incorporation of kidney outcomes found no passage establishing those methodological details. (LLM, conf=0.73)
Experimental — accuracy not yet measuredA second study found that at an annual cost of $4506, SGLT2i therapy would have an incremental cost-effectiveness ratio of $141 200 per QALY gained compared with prior GDMT.
“It found that at an annual cost of $4506, SGLT2i therapy would have an incremental cost-effectiveness ratio of $141 200 per QALY gained compared with prior GDMT.39”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The Access to Pharmacotherapies section discusses the affordability of SGLT2 inhibitors, but gives no annual price or cost-effectiveness estimate. Searches of our copy for $4506, $141,200, and cost-effectiveness per QALY found no passage reporting the claimed comparison with prior GDMT; page numbers were not available. (LLM, conf=0.76)
Experimental — accuracy not yet measuredTaken together, these analyses suggest that SGLT2i therapy is not cost-effective at current drug prices (incremental cost-effectiveness ratio ≥$120 000 per QALY gained).
“Taken together, these analyses suggest that SGLT2i therapy is not cost-effective at current drug prices (incremental cost-effectiveness ratio ≥$120 000 per QALY gained).”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The Access to Pharmacotherapies section (page unavailable) describes SGLT2 inhibitors as currently expensive and notes affordability barriers, but it does not assess whether they are cost-effective. Searches for cost-effectiveness, QALYs, and the $120,000 figure found no passage reporting the claimed incremental cost-effectiveness ratio. (LLM, conf=0.75)
Experimental — accuracy not yet measuredIn acute VTE, recurrence risk increases stepwise with the number of CKM syndrome components.
“In acute VTE, the risk of recurrence increases stepwise with the number of CKM syndrome components.2–4”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The STAGING RATIONALE section describes a stepwise increase in absolute cardiovascular disease risk across later CKM stages, not VTE recurrence risk by number of CKM components. Searches for acute VTE, recurrent venous thromboembolism, and component counts found no passage addressing the claimed association. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn Sleep AHEAD, people with T2D, obesity, and OSA who lost ≥10 kg via behavioral intervention had significant improvement in the AHI score.
“In the Sleep AHEAD (Sleep Apnea in Look Ahead-Action for Health in Diabetes) study,4 people with T2D, obesity, and OSA who lost ≥10 kg via behavioral intervention had significant improvement in the AHI score.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [4]
The Stage 1 CKM: Excess or Dysfunctional Adiposity section recommends lifestyle-supported weight loss, but does not report Sleep AHEAD results. Searches for Sleep AHEAD, AHI, and a ≥10 kg weight-loss threshold found no passage in our copy addressing the claimed improvement in apnea–hypopnea index. (LLM, conf=0.76)
Experimental — accuracy not yet measuredMeta-analyses and cohort studies have found women with CKD are at increased risk of APOs.
“Meta-analyses and cohort studies have found that women with CKD are at increased risk of APOs.9–11,39”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [39]
The Risk-Enhancing Factors section lists a history of adverse pregnancy outcomes as a risk enhancer for cardiovascular disease and kidney failure; it does not say that women with CKD have an increased risk of those outcomes. Searches for CKD with adverse pregnancy outcomes, preeclampsia, and preterm birth found no passage in our copy reporting the claimed association or the meta-analyses and cohort studies. (LLM, conf=0.72)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961 · see citing works
KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., et al. (2024) · Kidney International · doi:10.1016/j.kint.2023.10.018 · Cited by 8,530 · see citing works
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485 · see citing works
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000625 · Cited by 6,185 · see citing works
Self-citationHeidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001063 · Cited by 4,922 · see citing works
Prospective Studies Collaboration (2009) · The Lancet · doi:10.1016/s0140-6736(09)60318-4 · Cited by 4,807 · see citing works
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536 · see citing works
Self-citationWebster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017) · The Lancet · doi:10.1016/s0140-6736(16)32064-5 · Cited by 3,842 · see citing works
Obesity and cardiovascular disease: a scientific statement from the American Heart Association
Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J.-P., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000973 · Cited by 3,691 · see citing works
Self-citationA multisociety Delphi consensus statement on new fatty liver disease nomenclature
Rinella, M. E., Lazarus, J. V., Ratziu, V., Francque, S. M., Sanyal, A. J., Kanwal, F., Romero, D., Abdelmalek, M. F., Anstee, Q. M., Arab, J. P., et al. (2023) · Hepatology · doi:10.1097/hep.0000000000000520 · Cited by 3,476 · see citing works
Interventions for preventing obesity in children
Brown, T. J., Moore, T. H., Hooper, L., Gao, Y., Zayegh, A. M., Ijaz, S., Elwenspoek, M. M. C., Foxen, S. C., Magee, L., O’Malley, C. L., et al. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001871.pub4 · Cited by 2,996 · see citing works
Lloyd-Jones, D. M., Allen, N. B., Anderson, C. A. M., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001078 · Cited by 2,785 · see citing works
Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Baigent, C., Landray, M. J., Reith, C., Emberson, J., Wheeler, D. C., Tomson, C., Wanner, C., Krane, V., Cass, A., Craig, J., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60739-3 · Cited by 2,479 · see citing works
Giovannucci, E., Harlan, D. M., Archer, M. C., Bergenstal, R. M., Gapstur, S. M., Habel, L. A., Pollak, M., Regensteiner, J. G., & Yee, D. (2010) · Diabetes Care · doi:10.2337/dc10-0666 · Cited by 2,366 · see citing works
Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K. G., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)33102-1 · Cited by 2,095 · cited 1× · see citing works
“…loss and significant lifestyle changes, which have been associated with reductions in adipose tissue and improvements in glucose tolerance (stage 1) 142,143 ; remission of diabetes, 142 hypertension, 144 hyperlipidemia, 143 and MetS, as well as improvements in kidney function 145 (stage 2); and…”
BackgroundMalik, S., Wong, N. D., Franklin, S. S., Kamath, T. V., L'Italien, G. J., Pio, J. R., & Williams, G. R. (2004) · Circulation · doi:10.1161/01.cir.0000140677.20606.0e · Cited by 1,845 · see citing works
The National Committee for Quality Assurance
Iglehart, J. K. (1996) · New England Journal of Medicine · doi:10.1056/nejm199609263351322 · Cited by 1,839 · see citing works
Social determinants of health and diabetes: A scientific review
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2021) · Diabetes Care · doi:10.2337/dci20-0053 · Cited by 1,732 · see citing works
Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors
Juonala, M., Magnussen, C. G., Berenson, G. S., Venn, A., Burns, T. L., Sabin, M. A., Srinivasan, S. R., Daniels, S. R., Davis, P. H., Chen, W., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1010112 · Cited by 1,665 · see citing works
Adipose tissue dysfunction as determinant of obesity-associated metabolic complications
Longo, M., Zatterale, F., Naderi, J., Parrillo, L., Formisano, P., Raciti, G. A., Beguinot, F., & Miele, C. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20092358 · Cited by 1,575 · see citing works
Rangaswami, J., Bhalla, V., Blair, J. E., Chang, T. I., Costa, S. P., Lentine, K. L., Lerma, E. V., Mezue, K. N., Molitch, M. E., Müllens, W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000664 · Cited by 1,479 · see citing works
Self-citationAlexander, C. M., Landsman, P. B., Teutsch, S. M., & Haffner, S. M. (2003) · Diabetes · doi:10.2337/diabetes.52.5.1210 · Cited by 1,475 · see citing works
Ndumele, C. E., Neeland, I. J., Tuttle, K. R., Chow, S. L., Mathew, R. O., Khan, S. S., Coresh, J., Baker-Smith, C. M., Carnethon, M. R., Després, J.-P., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001186 · Cited by 1,405 · see citing works
Self-citationHampl, S. E., Hassink, S. G., Skinner, A. C., Armstrong, S. C., Barlow, S. E., Bolling, C. F., Avila Edwards, K. C., Eneli, I., Hamre, R., Joseph, M. M., et al. (2023) · Pediatrics · doi:10.1542/peds.2022-060640 · Cited by 1,389 · see citing works
Agarwal, R., Filippatos, G., Pitt, B., Anker, S. D., Rossing, P., Joseph, A., Kolkhof, P., Nowack, C., Gebel, M., Ruilope, L. M., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehab777 · Cited by 1,317 · cited 1× · see citing works
“103 Finerenone can be considered to reduce adverse cardiovascular and kidney events in patients with diabetes and CKD already on maximally tolerated renin-angiotensin system inhibition, 104 with or without SGLT2 inhibitor use.”
BackgroundPrediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age
Lloyd-Jones, D. M., Leip, E. P., Larson, M. G., D’Agostino, R. B., Beiser, A., Wilson, P. W. F., Wolf, P. A., & Levy, D. (2006) · Circulation · doi:10.1161/circulationaha.105.548206 · Cited by 1,298 · cited 1× · see citing works
“111–113 The 2018 AHA/American College of Cardiology cholesterol guidelines recommend strong consideration of statin therapy for all patients with diabetes who are 40 to 75 years of age even in the presence of a zero CAC score.”
BackgroundKidney disease and increased mortality risk in type 2 diabetes
Afkarian, M., Sachs, M. C., Kestenbaum, B., Hirsch, I. B., Tuttle, K. R., Himmelfarb, J., & de Boer, I. H. (2013) · Journal of the American Society of Nephrology · doi:10.1681/asn.2012070718 · Cited by 1,298 · see citing works
Self-citationNon-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome
Yki‐Järvinen, H. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70032-4 · Cited by 1,260 · see citing works
McGuire, D. K., Shih, W. J., Cosentino, F., Charbonnel, B., Cherney, D. Z. I., Dagogo-Jack, S., Pratley, R., Greenberg, M., Wang, S., Huyck, S., et al. (2021) · JAMA Cardiology · doi:10.1001/jamacardio.2020.4511 · Cited by 1,235 · see citing works
Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1.9 million people
Shah, A. D., Langenberg, C., Rapsomaniki, E., Denaxas, S., Pujades-Rodriguez, M., Gale, C. P., Deanfield, J., Smeeth, L., Timmis, A., & Hemingway, H. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70219-0 · Cited by 1,225 · see citing works
Metabolic Syndrome and Risk of Cancer
Esposito, K., Chiodini, P., Colao, A. A. L., Lenzi, A., & Giugliano, D. (2012) · Diabetes Care · doi:10.2337/dc12-0336 · Cited by 1,212 · see citing works
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000596 · Cited by 1,127 · see citing works
Self-citationCoronary Artery Calcium Score and Risk Classification for Coronary Heart Disease Prediction
Polonsky, T. S. (2010) · JAMA · doi:10.1001/jama.2010.461 · Cited by 1,123 · see citing works
Obesity in children and adolescents: epidemiology, causes, assessment, and management
Jebeile, H., Kelly, A. S., O'Malley, G., & Baur, L. A. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00047-x · Cited by 1,099 · see citing works
Baigent, C., Emberson, J., Haynes, R., Herrington, W. G., Judge, P., Landray, M. J., Mayne, K. J., Ng, S. Y. A., Preiss, D., Roddick, A. J., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)02074-8 · Cited by 1,020 · see citing works
Vaduganathan, M., Docherty, K. F., Claggett, B. L., Jhund, P. S., de Boer, R. A., Hernandez, A. F., Inzucchi, S. E., Kosiborod, M. N., Lam, C. S. P., Martinez, F., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01429-5 · Cited by 996 · see citing works
Self-citationObesity, Adipose Tissue and Vascular Dysfunction
Koenen, M., Hill, M. A., Cohen, P., & Sowers, J. R. (2021) · Circulation Research · doi:10.1161/circresaha.121.318093 · Cited by 953 · see citing works
Strict Blood-Pressure Control and Progression of Renal Failure in Children
The ESCAPE Trial Group (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0902066 · Cited by 951 · see citing works
Lifetime risks of cardiovascular disease
Berry, J. D., Dyer, A., Cai, X., Garside, D. B., Ning, H., Thomas, A., Greenland, P., Van Horn, L., Tracy, R. P., & Lloyd-Jones, D. M. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1012848 · Cited by 945 · see citing works
de Boer, I. H., Khunti, K., Sadusky, T., Tuttle, K. R., Neumiller, J. J., Rhee, C. M., Rosas, S. E., Rossing, P., & Bakris, G. (2022) · Diabetes Care · doi:10.2337/dci22-0027 · Cited by 919 · cited 2× · see citing works
“121,139 In patients with a propensity for hyper-kalemia, the addition of an oral antihyperkalemic agent such as patiromer acetate or sodium zirconium cyclosili-cate may allow maintenance of an RAAS inhibitor without the risk of hyperkalemia.”
BackgroundSelf-citationSocial Determinants of Cardiovascular Disease
Powell-Wiley, T. M., Baumer, Y., Baah, F. O., Baez, A. S., Farmer, N., Mahlobo, C. T., Pita, M. A., Potharaju, K. A., Tamura, K., & Wallen, G. R. (2022) · Circulation Research · doi:10.1161/circresaha.121.319811 · Cited by 904 · see citing works
Self-citationGrundy, S. M. (2016) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2015.10.004 · Cited by 882 · see citing works
Grundy, S. M., Hansen, B., Smith, S. C., Cleeman, J. I., Kahn, R. A., & Participants, F. C. (2004) · Circulation · doi:10.1161/01.cir.0000112379.88385.67 · Cited by 864 · see citing works
In-Center Hemodialysis Six Times per Week versus Three Times per Week
Chertow, G. M., Levin, N. W., Beck, G., Depner, T., Eggers, P. W., Gassman, J., Gorodetskaya, I., Greene, T., James, S. H., Larive, B., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1001593 · Cited by 859 · see citing works
Coughlin, S. R. (2004) · European Heart Journal · doi:10.1016/j.ehj.2004.02.021 · Cited by 840 · see citing works
Criqui, M. H., Matsushita, K., Aboyans, V., Hess, C. N., Hicks, C. W., Kwan, T., McDermott, M. M., Misra, S., & Ujueta, F. (2021) · Circulation · doi:10.1161/cir.0000000000001005 · Cited by 828 · see citing works
Khan, S. S., Coresh, J., Pencina, M. J., Ndumele, C. E., Rangaswami, J., Chow, S. L., Palaniappan, L. P., Sperling, L. S., Virani, S. S., Ho, J. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001191 · Cited by 797 · see citing works
Self-citationSaunders, J. T., Nambi, V., de Lemos, J. A., Chambless, L. E., Virani, S. S., Boerwinkle, E., Hoogeveen, R. C., Liu, X., Astor, B. C., Mosley, T. H., et al. (2011) · Circulation · doi:10.1161/circulationaha.110.005264 · Cited by 756 · see citing works
Self-citationClustering of metabolic factors and coronary heart disease
Wilson, P. W. F., Kannel, W. B., Silbershatz, H., & D'Agostino, R. B. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.10.1104 · Cited by 712 · see citing works
Ledwidge, M., Gallagher, J., Conlon, C., Tallon, E., O’Connell, E., Dawkins, I., Watson, C., O’Hanlon, R., Bermingham, M., Patle, A., et al. (2013) · JAMA · doi:10.1001/jama.2013.7588 · Cited by 664 · see citing works
Joseph, J. J., Deedwania, P., Acharya, T., Aguilar, D., Bhatt, D. L., Chyun, D. A., Di Palo, K. E., Golden, S. H., Sperling, L. S., & on behalf of the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, T. A. V. B. C. O. C. C. A. C. O. H. (2022) · Circulation · doi:10.1161/cir.0000000000001040 · Cited by 660 · see citing works
Self-citationTuttle, K. R., Lakshmanan, M. C., Rayner, B., Busch, R. S., Zimmermann, A. G., Woodward, D. B., & Botros, F. T. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(18)30104-9 · Cited by 648 · see citing works
Self-citationAccountable Health Communities — Addressing Social Needs through Medicare and Medicaid
Alley, D. E., Asomugha, C. N., Conway, P. H., & Sanghavi, D. M. (2016) · New England Journal of Medicine · doi:10.1056/nejmp1512532 · Cited by 606 · see citing works
Metabolic Syndrome and Incident Diabetes
Ford, E. S., Li, C., & Sattar, N. A. (2008) · Diabetes Care · doi:10.2337/dc08-0423 · Cited by 575 · see citing works
Recent trends in cardiovascular mortality in the United States and public health goals.
Sidney, S., Quesenberry, C. P., Jaffe, M. G., Sorel, M., Nguyen-Huynh, M. N., Kushi, L. H., Go, A. S., & Rana, J. S. (2016) · JAMA Cardiology · doi:10.1001/jamacardio.2016.1326 · Cited by 569 · see citing works
Metabolic Syndrome and Kidney Disease: A Systematic Review and Meta-analysis
Thomas, G., Sehgal, A. R., Kashyap, S. R., Srinivas, T. R., Kirwan, J. P., & Navaneethan, S. D. (2011) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.02180311 · Cited by 553 · see citing works
Chung, M. K., Eckhardt, L. L., Chen, L. Y., Ahmed, H. M., Gopinathannair, R., Joglar, J. A., Noseworthy, P. A., Pack, Q. R., Sanders, P., & Trulock, K. M. (2020) · Circulation · doi:10.1161/cir.0000000000000748 · Cited by 549 · see citing works
The impact of maternal obesity on maternal and fetal health.
Leddy, M. A., Power, M. L., & Schulkin, J. A. (2008) · PubMed Central · Cited by 547 · see citing works
The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease
Remuzzi, G., Perico, N., Macia, M. L., & Ruggenenti, P. L. (2005) · Kidney International · doi:10.1111/j.1523-1755.2005.09911.x · Cited by 505 · see citing works
Marx, N., Husain, M., Lehrke, M., Verma, S., & Sattar, N. A. (2022) · Circulation · doi:10.1161/circulationaha.122.059595 · Cited by 500 · see citing works
NHSR 158. National Health and Nutrition Examination Survey 2017–March 2020 Pre-pandemic Data Files
Bryan, S., Afful, J., Carroll, M., Te-Ching, C., Orlando, D., Fink, S., & Fryar, C. (2021) · doi:10.15620/cdc:106273 · Cited by 479 · see citing works
10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Das, S. R., Hilliard, M. E., Isaacs, D., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s010 · Cited by 465 · cited 3× · see citing works
“…from the American Diabetes Association suggests that diagnostic testing for subclinical HF should likely be based on age and comorbidity profile, 68 but the optimal strategy for identifying subclinical HF in the population, reflecting both clinical benefit and cost-effectiveness, is still being…”
BackgroundInfluentialSelf-citationWatanabe, H., Tanabe, N., Watanabe, T., Darbar, D., Roden, D. M., Sasaki, S., & Aizawa, Y. (2008) · Circulation · doi:10.1161/circulationaha.107.744466 · Cited by 427 · see citing works
Cardiovascular Disease in Children with Chronic Kidney Disease
Mitsnefes, M. M. (2012) · Journal of the American Society of Nephrology · doi:10.1681/asn.2011111115 · Cited by 416 · see citing works
Relationship between physical activity, body mass index, and risk of heart failure
Pandey, A., LaMonte, M., Klein, L., Ayers, C., Psaty, B. M., Eaton, C. B., Allen, N. B., de Lemos, J. A., Carnethon, M., Greenland, P., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.081 · Cited by 398 · see citing works
Self-citationEberly, L. A., Yang, L., Eneanya, N. D., Essien, U., Julien, H., Nathan, A. S., Khatana, S. A. M., Dayoub, E. J., Fanaroff, A. C., Giri, J., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.6139 · Cited by 350 · see citing works
Chertow, G. M., Normand, S. T., & McNeil, B. J. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000135969.33773.0b · Cited by 335 · see citing works
Kreuter, M. W., Thompson, T., McQueen, A., & Garg, R. (2020) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-090419-102204 · Cited by 305 · see citing works
Garg, A., Butz, A. M., Dworkin, P. H., Lewis, R. A., Thompson, R. E., & Serwint, J. R. (2007) · Pediatrics · doi:10.1542/peds.2007-0398 · Cited by 301 · see citing works
Lifetime Risk and Years Lived Free of Total Cardiovascular Disease
Wilkins, J. T., Ning, H., Berry, J. D., Zhao, L., Dyer, A. R., & Lloyd‐Jones, D. M. (2012) · JAMA · doi:10.1001/jama.2012.14312 · Cited by 293 · see citing works
Cardiovascular Complications of Diabetic Kidney Disease
Pálsson, R., & Patel, U. D. (2014) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2014.03.003 · Cited by 292 · see citing works
Blumenthal, J. A., Sherwood, A., Gullette, E. C. D., Babyak, M., Waugh, R., Georgiades, A., Craighead, L. W., Tweedy, D., Feinglos, M., Appelbaum, M., et al. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.13.1947 · Cited by 289 · see citing works
Eberly, L. A., Yang, L., Essien, U. R., Eneanya, N. D., Julien, H. M., Luo, J., Nathan, A. S., Khatana, S. A. M., Dayoub, E. J., Fanaroff, A. C., et al. (2021) · JAMA Health Forum · doi:10.1001/jamahealthforum.2021.4182 · Cited by 288 · see citing works
Screening Children for Social Determinants of Health: A Systematic Review
Sokol, R. L., Austin, A. E., Chandler, C., Byrum, E., Bousquette, J., Lancaster, C., Doss, G., Dotson, A. B., Urbaeva, V., Singichetti, B., et al. (2019) · PEDIATRICS · doi:10.1542/peds.2019-1622 · Cited by 282 · see citing works
Cheng, J., Zhang, W., Zhang, X., Han, F., Li, X., He, X., Li, Q., & Chen, J. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.348 · Cited by 281 · see citing works
de Boer, I. H., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., et al. (2020) · Kidney International · doi:10.1016/j.kint.2020.06.024 · Cited by 278 · see citing works
Self-citationTuttle, K. R., Alicic, R. Z., Duru, O. K., Jones, C. R., Daratha, K. B., Nicholas, S. B., McPherson, S. M., Neumiller, J. J., Bell, D. S., Mangione, C. M., et al. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.18169 · Cited by 275 · see citing works
Self-citationShihab, H. M., Meoni, L. A., Chu, A. Y., Wang, N.-Y., Ford, D. E., Liang, K.-Y., Gallo, J. J., & Klag, M. J. (2012) · Circulation · doi:10.1161/circulationaha.112.117333 · Cited by 274 · see citing works
Hemmingsson, E. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0310-2 · Cited by 261 · see citing works
Obesity and subtypes of incident cardiovascular disease
Ndumele, C. E., Matsushita, K., Lazo, M., Bello, N., Blumenthal, R. S., Gerstenblith, G., Nambi, V., Ballantyne, C. M., Solomon, S. D., Selvin, E., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003921 · Cited by 259 · see citing works
Self-citationHypertension in Diabetic Nephropathy: Epidemiology, Mechanisms, and Management
Buren, P. N. V., & Toto, R. (2011) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2010.10.003 · Cited by 256 · see citing works
Metabolic Syndrome and the Risk of Mild Cognitive Impairment and Progression to Dementia
Ng, T. P., Feng, L., Nyunt, M. S. Z., Feng, L., Gao, Q., Lim, M. L., Collinson, S. L., Chong, M. S., Lim, W. S., Lee, T.-S. W., et al. (2016) · JAMA Neurology · doi:10.1001/jamaneurol.2015.4899 · Cited by 253 · see citing works
Adoption of Social Determinants of Health EHR Tools by Community Health Centers
Gold, R., Bunce, A., Cowburn, S., Dambrun, K., Dearing, M., Middendorf, M., Mossman, N., Hollombe, C., Mahr, P., Melgar, G., et al. (2018) · The Annals of Family Medicine · doi:10.1370/afm.2275 · Cited by 252 · see citing works
From conception to infancy — early risk factors for childhood obesity
Larqué, E., Labayen, I., Flodmark, C., Lissau, I., Czernin, S., Moreno, L. A., Pietrobelli, A., & Widhalm, K. (2019) · Nature Reviews Endocrinology · doi:10.1038/s41574-019-0219-1 · Cited by 251 · see citing works
Brewster, U. C., Perazella, M. A., & Setaro, J. F. (2003) · The American Journal of the Medical Sciences · doi:10.1097/00000441-200307000-00003 · Cited by 241 · see citing works
Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index
Palaniappan, L. P., Wong, E. C., Shin, J., Fortmann, S. P., & Lauderdale, D. S. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.152 · Cited by 238 · see citing works
Self-citationButler, J., Anker, S. D., Lund, L. H., Coats, A. J. S., Filippatos, G. S., Siddiqi, T. J., Friede, T., Fabien, V., Kosiborod, M., Metra, M., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac401 · Cited by 238 · see citing works
Self-citationAddressing Unmet Basic Resource Needs as Part of Chronic Cardiometabolic Disease Management
Berkowitz, S. A., Hulberg, A. C., Standish, S., Reznor, G., & Atlas, S. J. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.7691 · Cited by 237 · see citing works
Beldhuis, I. E., Lam, C. S. P., Testani, J. M., Voors, A. A., Spall, H. G. C. V., ter Maaten, J. M., & Damman, K. (2022) · Circulation · doi:10.1161/circulationaha.121.052792 · Cited by 233 · see citing works
Malik, S., Zhao, Y., Budoff, M., Nasir, K., Blumenthal, R. S., Bertoni, A. G., & Wong, N. D. (2017) · JAMA Cardiology · doi:10.1001/jamacardio.2017.4191 · Cited by 215 · see citing works
Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2015.05.013 · Cited by 210 · see citing works
Doumouras, A. G., Wong, J. A., Paterson, J. M., Lee, Y., Sivapathasundaram, B., Tarride, J.-E., Thabane, L., Hong, D., Yusuf, S., & Anvari, M. (2021) · Circulation · doi:10.1161/circulationaha.120.052386 · Cited by 209 · see citing works
Cainzos-Achirica, M., Miedema, M. D., McEvoy, J. W., Al Rifai, M., Greenland, P., Dardari, Z., Budoff, M., Blumenthal, R. S., Yeboah, J., Duprez, D. A., et al. (2020) · Circulation · doi:10.1161/circulationaha.119.045010 · Cited by 201 · see citing works
Rangaswami, J., Bhalla, V., de Boer, I. H., Staruschenko, A., Sharp, J. A., Singh, R. R., Lo, K. B., Tuttle, K., Vaduganathan, M., Ventura, H., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000920 · Cited by 192 · see citing works
Self-citationLai, C.-C., Sun, D., Cen, R., Wang, J., Li, S., Fernandez‐Alonso, C., Chen, W., Srinivasan, S. R., & Berenson, G. S. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.05.072 · Cited by 191 · see citing works
Yan, Q., Chen, Z., Wang, Y., Campbell, J. A., Xue, Q., Williams, M. Y., Weinhardt, L. S., & Egede, L. E. (2022) · Health Equity · doi:10.1089/heq.2022.0010 · Cited by 181 · see citing works
Effect of Weight Loss with Reduction of Intra-Abdominal Fat on Lipid Metabolism in Older Men
Purnell, J. Q. (2000) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.85.3.977 · Cited by 161 · see citing works
Recommendations for Addressing Structural Racism in Implementation Science: A Call to the Field
Shelton, R. C., Adsul, P., & Oh, A. (2021) · Ethnicity & Disease · doi:10.18865/ed.31.s1.357 · Cited by 156 · see citing works
Müllens, W., Martens, P., Testani, J. M., Tang, W. H. W., Skouri, H. N., Verbrugge, F. H., Fudim, M., Iacoviello, M., Franke, J., Flammer, A. J., et al. (2022) · European Journal of Heart Failure · doi:10.1002/ejhf.2471 · Cited by 148 · see citing works
Page, K. A., LUO, S. H., Wang, X., Chow, T., Alves, J. M., Buchanan, T. A., & Xiang, A. H. (2019) · Diabetes Care · doi:10.2337/dc18-2581 · Cited by 144 · see citing works
Biomarker-based risk prediction of incident heart failure in pre-diabetes and diabetes
Pandey, A., Vaduganathan, M., Patel, K. V., Ayers, C., Ballantyne, C. M., Kosiborod, M. N., Carnethon, M., DeFilippi, C., McGuire, D. K., Khan, S. S., et al. (2021) · JACC: Heart Failure · doi:10.1016/j.jchf.2020.10.013 · Cited by 144 · see citing works
Self-citationTirosh, A., Golan, R., Harman‐Boehm, I., Henkin, Y., Schwarzfuchs, D., Rudich, A., Kovsan, J., Fiedler, M., Blüher, M., Stümvoll, M., et al. (2013) · Diabetes Care · doi:10.2337/dc12-1846 · Cited by 130 · see citing works
Chronic kidney disease and life expectancy
Turin, T. C., Tonelli, M. A., Manns, B., Ravani, P., Ahmed, S. B., & Hemmelgarn, B. R. (2012) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfs052 · Cited by 130 · see citing works
American Academy of Family Physicians (AAFP)
Zhang, Y. (2008) · Encyclopedia of Global Health · doi:10.4135/9781412963855.n49 · Cited by 130 · see citing works
Persistence of Risk for Type 2 Diabetes After Gestational Diabetes Mellitus
Díaz-Santana, M. V., O’Brien, K. M., Park, Y., Sandler, D. P., & Weinberg, C. R. (2022) · Diabetes Care · doi:10.2337/dc21-1430 · Cited by 128 · see citing works
Cottrell, E. K., Hendricks, M., Dambrun, K., Cowburn, S., Pantell, M., Gold, R., & Gottlieb, L. M. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.16852 · Cited by 126 · cited 1× · see citing works
“147 In addition, health care systems can address social needs among patients with CKM syndrome by identifying, using and referring to existing community resources.”
BackgroundPerl, J. M., Brown, E. A., Chan, C. T., Couchoud, C., Davies, S., Kazancıoğlu, R., Klarenbach, S. W., Liew, A., Weiner, D. E., Cheung, M., et al. (2023) · Kidney International · doi:10.1016/j.kint.2023.01.006 · Cited by 126 · see citing works
Self-citationSubclinical Atherosclerosis Measures for Cardiovascular Prediction in CKD
Matsushita, K., Sang, Y., Ballew, S. H., Shlipak, M. G., Katz, R., Rosas, S. E., Peralta, C. A., Woodward, M., Kramer, H., Jacobs, D. R., et al. (2014) · Journal of the American Society of Nephrology · doi:10.1681/asn.2014020173 · Cited by 121 · see citing works
Self-citationRevisiting the Social History for Child Health
Kenyon, C., Sandel, M., Silverstein, M., Shakir, A., & Zuckerman, B. (2007) · Pediatrics · doi:10.1542/peds.2006-2495 · Cited by 120 · see citing works
Long-Term Changes in Cardiac Structure and Function Following Bariatric Surgery
Sorimachi, H., Obokata, M., Omote, K., Reddy, Y. N. V., Takahashi, N., Koepp, K. E., Ng, A. C. T., Rider, O. J., & Borlaug, B. A. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.08.738 · Cited by 117 · see citing works
Liu, Z., Gao, P., Gao, A.-Y., Lin, Y., Feng, X.-X., Zhang, F., Xu, L.-Q., Niu, W.-Y., Fang, H., Zhou, S., et al. (2022) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2021.4375 · Cited by 116 · see citing works
Emmons, K. M., & Chambers, D. (2021) · Ethnicity & Disease · doi:10.18865/ed.31.1.133 · Cited by 114 · see citing works
KDOQI US Commentary on the 2013 KDIGO Clinical Practice Guideline for Lipid Management in CKD
Sarnak, M. J., Bloom, R. D., Muntner, P., Rahman, M., Saland, J. M., Wilson, P. W. F., & Fried, L. P. (2014) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2014.10.005 · Cited by 113 · see citing works
Bansal, N., Artinian, N. T., Bakris, G. L., Chang, T. I., Cohen, J. B., Flythe, J. E., Lea, J. P., Vongpatanasin, W., & Chertow, G. M. (2023) · Hypertension · doi:10.1161/hyp.0000000000000230 · Cited by 93 · see citing works
Management of Obesity in Cardiovascular Practice
Després, J.-P., Carpentier, A. C., Tchernof, A., Neeland, I. J., & Poirier, P. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.05.035 · Cited by 87 · see citing works
Self-citationMetabolic Syndrome and Risk of Incident Peripheral Artery Disease
Garg, P. K., Biggs, M. L., Carnethon, M. R., Ix, J. H., Criqui, M. H., Britton, K. A., Djoussé, L., Sutton-Tyrrell, K., Newman, A. B., Cushman, M., et al. (2013) · Hypertension · doi:10.1161/hypertensionaha.113.01925 · Cited by 80 · see citing works
Self-citationCardio-Renal-Metabolic Care Models
Rangaswami, J., Tuttle, K. R., & Vaduganathan, M. (2020) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.120.007264 · Cited by 80 · see citing works
Self-citationEffects of intentional weight loss in patients with obesity and heart failure: a systematic review
McDowell, K., Petrie, M. C., Raihan, N. A., & Logue, J. (2018) · Obesity Reviews · doi:10.1111/obr.12707 · Cited by 73 · see citing works
Höskuldsdóttir, G., Sattar, N., Miftaraj, M., Näslund, I., Ottosson, J., Franzén, S., Svensson, A., & Eliasson, B. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.019323 · Cited by 70 · see citing works
Genome-wide DNA methylation variation in maternal and cord blood of gestational diabetes population
Kang, J., Lee, C., Li, H., Hsu, K.-H., & Lin, S. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.07.034 · Cited by 67 · see citing works
Hicks, C. W., Yang, C., Ndumele, C. E., Folsom, A. R., HEISS, G. M., Black, J. H., Selvin, E., & Matsushita, K. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008644 · Cited by 65 · see citing works
Self-citationAssayag, E. B., Eldor, R., Korczyn, A. D., Kliper, E., Shenhar‐Tsarfaty, S., Tene, O., Molad, J., Shapira, I., Berliner, S. A., Volfson, V., et al. (2017) · Stroke · doi:10.1161/strokeaha.117.017709 · Cited by 64 · see citing works
Sarnak, M. J., Auguste, B. L., Brown, E. A., Chang, A. R., Chertow, G. M., Hannan, M. F., Herzog, C. A., Nadeau‐Fredette, A., Tang, W. H. W., Wang, A. Y.-M., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001088 · Cited by 63 · see citing works
Diabetes and all-cause mortality, a 18-year follow-up study
Salehidoost, R., Mansouri, A., Amini, M., Yamini, S. A., & Aminorroaya, A. (2020) · Scientific Reports · doi:10.1038/s41598-020-60142-y · Cited by 60 · see citing works
Heart Failure in End-Stage Kidney Disease: Pathophysiology, Diagnosis, and Therapeutic Strategies.
Rangaswami, J., & McCullough, P. (2018) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2018.08.005 · Cited by 52 · see citing works
Self-citationReclassification of Pre-Heart Failure Stages Using Cardiac Biomarkers
Jia, X., Rifai, M. A., Ndumele, C. E., Virani, S. S., de Lemos, J. A., Lee, E., Shah, A. M., Echouffo-Tcheugui, J. B., Bozkurt, B., Hoogeveen, R. C., et al. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2022.12.005 · Cited by 45 · see citing works
Self-citationNutrition Disparities and Cardiovascular Health
Mensah, G. A., Brown, A. G. M., & PRATT, C. A. (2020) · Current Atherosclerosis Reports · doi:10.1007/s11883-020-0833-3 · Cited by 39 · see citing works
Worsening Kidney Function Is the Major Mechanism of Heart Failure in Hypertension
Khayyat‐Kholghi, M., Oparil, S., Davis, B. R., & Tereshchenko, L. G. (2020) · JACC Heart Failure · doi:10.1016/j.jchf.2020.09.006 · Cited by 38 · see citing works
Zhang, H., Huang, T., Shen, W., Xu, X., Yang, P., Zhu, D., Fang, H., Wan, H., Wu, T., Wu, Y., et al. (2020) · ESC Heart Failure · doi:10.1002/ehf2.12974 · Cited by 36 · see citing works
Feng, Y., Yin, Y., Deng, R., & Li, H. (2020) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1111/jcpt.13243 · Cited by 35 · see citing works
Nielsen, E. E., Feinberg, J. B., Bu, F.-L., Olsen, M. H., Raymond, I. E., Steensgaard-Hansen, F., & Jakobsen, J. C. (2020) · Open Heart · doi:10.1136/openhrt-2020-001294 · Cited by 35 · see citing works
The Affordability of Guideline-Directed Medical Therapy
Sandhu, A. T., & Heidenreich, P. A. (2021) · Circulation · doi:10.1161/circulationaha.120.053291 · Cited by 32 · see citing works
Gallagher, C., Corl, A., & Dietz, W. H. (2021) · Obesity · doi:10.1002/oby.23154 · Cited by 32 · see citing works
Implications of specialist density for diabetes care in the United States.
Patel, R. B., Al Rifai, M., McEvoy, J. W., & Vaduganathan, M. (2019) · JAMA Cardiology · doi:10.1001/jamacardio.2019.3796 · Cited by 28 · see citing works
Jung, C., Yun, H., Park, J. T., Joo, Y. S., Kim, H. W., Yoo, T., Kang, S., Lee, J., Chae, D., Chung, W., et al. (2022) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfac194 · Cited by 22 · see citing works
Heart Failure Risk Associated With Severity of Modifiable Heart Failure Risk Factors: The ARIC Study
HAMO, C. E., Kwak, L., Wang, D., Florido, R., Echouffo‐Tcheugui, J. B., Blumenthal, R. S., Loehr, L., Matsushita, K., Nambi, V., Ballantyne, C. M., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.021583 · Cited by 20 · see citing works
Self-citationSocial Disadvantage: Perpetual Origin of Kidney Disease
Crews, D. C., & Hall, Y. N. (2015) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2014.11.003 · Cited by 18 · see citing works
Mechanistic Insights in Cardiorenal Syndrome
Lo, K. B., & Rangaswami, J. (2022) · NEJM Evidence · doi:10.1056/evidra2200053 · Cited by 17 · see citing works
Self-citationBurden, access, and disparities in kidney disease
Crews, D. C., Bello, A. K., & Saadi, G. E. (2019) · Clinical Nephrology · doi:10.5414/cn91wkdedi · Cited by 11 · see citing works
Gjyriqi, G., York, M., Abuazzam, F., Herzog, C. A., Bangalore, S., Lo, K. B., Sidhu, M. S., Vaduganathan, M., Rangaswami, J., & Mathew, R. O. (2022) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2022.10.432 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Ndumele, C. E., Neeland, I. J., Tuttle, K. R., Chow, S. L., Mathew, R. O., Khan, S. S., Coresh, J., Baker-Smith, C. M., Carnethon, M. R., Després, J.-P., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001186 · Cited by 1,405 · see citing works
Self-citationDevelopment and validation of the American Heart Association’s PREVENT equations
Khan, S. S., Matsushita, K., Sang, Y., Ballew, S. H., Grams, M. E., Surapaneni, A., Blaha, M. J., Carson, A. P., Chang, A. R., Ciemins, E., et al. (2024) · Circulation · doi:10.1161/circulationaha.123.067626 · Cited by 1,234 · see citing works
“12,13 Poor CKM health is increasing in prevalence, is associated with earlier onset of CVD, and disproportionately affects racial and ethnic minoritized individuals who experience a greater burden of adverse social factors 14–16 (eg, residing in neighborhoods with high social deprivation 17,18 ).”
BackgroundMethodSelf-citationMartin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Beaton, A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001303 · Cited by 1,206 · see citing works
Self-citationKhan, S. S., Coresh, J., Pencina, M. J., Ndumele, C. E., Rangaswami, J., Chow, S. L., Palaniappan, L. P., Sperling, L. S., Virani, S. S., Ho, J. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001191 · Cited by 797 · see citing works
Self-citationPrevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages in US Adults, 2011-2020
Aggarwal, R., Ostrominski, J. W., & Vaduganathan, M. (2024) · JAMA · doi:10.1001/jama.2024.6892 · Cited by 571 · see citing works
Neeland, I. J., Lim, S., Tchernof, A., Gastaldelli, A., Rangaswami, J., Ndumele, C. E., Powell-Wiley, T. M., & Després, J.-P. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00563-5 · Cited by 463 · see citing works
“This concept was highlighted in 2023 in the AHA’s Presidential Advisory 136 and Scientific Statement 12 on CKM syndrome, emphasizing the importance of a holistic approach to managing the interrelated risk factors of MetS, diabetes mellitus, CKD and CVD due to excess and/or dysfunctional adiposity.”
InfluentialSelf-citationMaddox, K. E. J., Elkind, M. S. V., Aparicio, H. J., Commodore-Mensah, Y. Y., de Ferranti, S. D., Dowd, W. N., Hernandez, A. F., Khavjou, O., Michos, E. D., Palaniappan, L. P., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001256 · Cited by 397 · see citing works
Self-citationCardiovascular-Kidney-Metabolic (CKM) syndrome: A state-of-the-art review
Sebastian, S. A., Padda, I., & Johal, G. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.102344 · Cited by 362 · see citing works
Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial
Ryan, D. H., Lingvay, I., Deanfield, J., Kahn, S. E., Barros, E., Burguera, B., Colhoun, H. M., Cercato, C., Dicker, D., Horn, D. B., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-02996-7 · Cited by 347 · see citing works
“Excess abnormal body fat, especially visceral adiposity and ectopic fat, is a driver of cardiovascular (CV) disease (CVD) 3–5 , and contributes to the global chronic disease burden of diabetes, chronic kidney disease, cancer and other chronic conditions 6,7 .”
BackgroundJones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., et al. (2025) · Hypertension · doi:10.1161/hyp.0000000000000249 · Cited by 386 · see citing works
Self-citationPalaniappan, L. P., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Currie, M. E., Earlie, R. S., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001412 · Cited by 312 · see citing works
Self-citationJones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., et al. (2025) · JACC · doi:10.1016/j.jacc.2025.05.007 · Cited by 280 · see citing works
Self-citation2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia
Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., et al. (2026) · JACC · doi:10.1016/j.jacc.2025.11.016 · Cited by 304 · see citing works
Self-citationLi, W., Shen, C., Kong, W., Zhou, X., Fan, H., Zhang, Y., Liu, Z., & Zheng, L. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02352-6 · Cited by 251 · see citing works
“It is notable that in the CKM staging framework, the AHA considers testing individuals in the preclinical stages to be of significant importance and emphasises that research on stages 0 to 3 CKM populations should focus on the prevention of CVD events [1].”
BackgroundMethodInfluentialJones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001356 · Cited by 295 · see citing works
Self-citationPrevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages by Social Determinants of Health
Zhu, R., Wang, R., He, J., Wang, L., Chen, H., Niu, X., Sun, Y., Guan, Y., Gong, Y., Zhang, L., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.45309 · Cited by 208 · see citing works
Romagnani, P., Agarwal, R., Chan, J. C. N., Levin, A., Kalyesubula, R., Karam, S., Nangaku, M., Rodríguez‐Iturbe, B., & Anders, H. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00589-9 · Cited by 226 · see citing works
“Health promotion and lifestyle modification works by reducing the prevalence of obesity, dyslipidaemia and hyperglycaemia, referred to as the cardiovascular–kidney–metabolic syndrome 158 .”
Plozasiran for Managing Persistent Chylomicronemia and Pancreatitis Risk
Watts, G. F., Rosenson, R. S., Hegele, R. A., Goldberg, I. J., Gallo, A., Mertens, A., Baass, A., Zhou, R., Muhsin, M., Hellawell, J., et al. (2025) · New England Journal of Medicine · doi:10.1056/nejmoa2409368 · Cited by 178 · see citing works
Chew, N., Mehta, A., Goh, R. S. J., Zhang, A. A. Y., Chen, Y., Chong, B., Chew, H. S. J., Shabbir, A., Brown, A. C., Dimitriadis, G. K., et al. (2024) · Circulation · doi:10.1161/circulationaha.124.070535 · Cited by 185 · see citing works
“43 Future studies are necessary to evaluate the improvements in discrimination and net reclassification with the incorporation of MASLD in modified risk assessment tools.”
Self-citationLi, N., Li, Y., Cui, L., Shu, R., Song, H., Wang, J., Chen, S., Liu, B., Shi, H., Gao, H., et al. (2024) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.118585 · Cited by 182 · see citing works
The impact of population ageing on the burden of chronic kidney disease
Chesnaye, N. C., Ortíz, A., Zoccali, C., Stel, V. S., & Jager, K. J. (2024) · Nature Reviews Nephrology · doi:10.1038/s41581-024-00863-9 · Cited by 185 · see citing works
“However, compliance with lifestyle interventions is limited owing to multiple factors, including socioeconomic issues 121 .”
The interplay of factors in metabolic syndrome: understanding its roots and complexity
Islam, M. S., Wei, P., Suzauddula, M., Nime, I., Feroz, F., Acharjee, M., & Pan, F. (2024) · Molecular Medicine · doi:10.1186/s10020-024-01019-y · Cited by 171 · see citing works
Singh, A. P., Shadangi, S., Gupta, P. K., & Rana, S. (2025) · Comprehensive physiology · doi:10.1002/cph4.70003 · Cited by 183 · see citing works
Vaduganathan, M., Filippatos, G. S., Claggett, B. L., Desai, A. S., Jhund, P. S., Henderson, A. D., BRINKER, M. D., Kolkhof, P., Schloemer, P., Lay‐Flurrie, J., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-03264-4 · Cited by 166 · see citing works
“This cardiovascular-kidney-metabolic (CKM) overlap is increasingly recognized, and there is potential for individual therapies to simultaneously improve multiple adjacent disease states 4 .”
Borlaug, B. A., Zile, M. R., Kramer, C. M., Baum, S. J., Hurt, K. C., Litwin, S. E., Murakami, M., Yang, O., Upadhyay, N., & Packer, M. (2024) · Nature Medicine · doi:10.1038/s41591-024-03374-z · Cited by 161 · see citing works
Social Risk Profile and Cardiovascular‐Kidney‐Metabolic Syndrome in US Adults
Li, J., Lei, L., Wang, W., Ding, W., Yu, Y., Pu, B., Peng, Y., Li, Y., Zhang, L., & Guo, Y. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.124.034996 · Cited by 141 · see citing works
Zhang, P., Mo, D.-G., Zeng, W., & Dai, H. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02642-7 · Cited by 135 · see citing works
“At the same time, the AHA Scientific Advisory Panel asserts that management strategies for CKM syndrome stage 0–3 should prioritize the prevention of cardiovascular events [7].”
Mhaimeed, O., Burney, Z. A., Schott, S. L., Kohli, P., Marvel, F. A., & Martin, S. S. (2024) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2024.100649 · Cited by 136 · see citing works
“Once patients develop subclinical cardio-vascular disease overlapping with CKM risk factors, they are in stage 3, and they are in stage 4 once they have clinical cardiovascular disease overlapping with CKM risk factors [35,36].”
BackgroundInfluentialTheodorakis, N., & Nikolaou, M. (2025) · Biomolecules · doi:10.3390/biom15020213 · Cited by 142 · see citing works
“[8,9]. the development and progression of atherosclerosis, HF, and CKD [5,6]. now part of the definition and diagnosis of MASLD, which was previously termed non-alcoholic fatty liver disease (NAFLD) before 2023 [7].”
Writing Committee Members, Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001423 · Cited by 122 · see citing works
Self-citationAlbuminuria in Cardiovascular, Kidney, and Metabolic Disorders: A State-of-the-Art Review
Claudel, S. E., & Verma, A. (2025) · Circulation · doi:10.1161/circulationaha.124.071079 · Cited by 131 · see citing works
“115,116 These therapies include angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), sodium-glucose cotransporter-2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP1-RAs), and mineralocorticoid receptor antagonists (MRAs).”
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s010 · Cited by 107 · see citing works
Diabetes in China: epidemiology, pathophysiology and multi-omics
Jia, W., Chan, J. C. N., Wong, T. Y., & Fisher, E. B. (2025) · Nature Metabolism · doi:10.1038/s42255-024-01190-w · Cited by 106 · see citing works
“Therefore, control of CKM risk factors using medications and promoting self-management with regular assessments is an area where physicians can make substantial impacts in changing the outcomes of people with diabetes in China 53 .”
Diao, J. A., Shi, I., Murthy, V. L., Buckley, T. A., Patel, C. J., Pierson, E., Yeh, R. W., Kazi, D. S., Wadhera, R. K., & Manrai, A. K. (2024) · JAMA · doi:10.1001/jama.2024.12537 · Cited by 102 · see citing works
Navaneethan, S. D., Bansal, N., Cavanaugh, K. L., Chang, A. R., Crowley, S. T., Delgado, C., Estrella, M. M., Ghossein, C., Ikizler, T. A., Koncicki, H. M., et al. (2024) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2024.08.003 · Cited by 108 · see citing works
“18,147 Extending education and implementation efforts across nephrology, primary care, endocrinology, cardiology, and pharmacy could encourage the use of GLP1 receptor agonists and other guideline-directed medical therapies for patients with CKM conditions.”
InfluentialSelf-citationGlobal Burden of the Key Components of Cardiovascular-Kidney-Metabolic Syndrome
Xie, Z., Yu, C., Cui, Q., Zhao, X., Zhuang, J., Chen, S., Guan, H., & Li, J. (2025) · Journal of the American Society of Nephrology · doi:10.1681/asn.0000000658 · Cited by 99 · see citing works
Cardiovascular-kidney-metabolic syndrome – An integrative review
Kittelson, K. S., Gasparotto, A., Fillmore, N., & Gomes, R. D. S. (2024) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2024.10.012 · Cited by 102 · see citing works
Cumulative Incidence of Mortality Associated with Cardiovascular–Kidney–Metabolic (CKM) Syndrome
Claudel, S. E., Schmidt, I. M., Waikar, S. S., & Verma, A. (2025) · Journal of the American Society of Nephrology · doi:10.1681/asn.0000000637 · Cited by 98 · see citing works
Yue, Y., Li, P., Sun, Z., Murayama, R., Li, Z., Hashimoto, K., & Zhang, Y. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02854-x · Cited by 97 · see citing works
“The following formulas were used for calculation [28, 29, 33, 34]: Based on the American Heart Association’s advisory framework [2], CKM syndrome is categorized into five stages (0 to 4).”
Ou, H., Wei, M., Li, X., & Xia, X. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02848-9 · Cited by 93 · see citing works
“The CTI index is calculated according to this formula [23] : CTI = 0.412 × Ln (CRP [mg/L]) + Ln (TG [mg/ dl] × FPG [mg/dl])/2.”
InfluentialZhang, N., Liu, X., Wang, L., Zhang, Y., Xiang, Y., Cai, J., Xu, H. Y., Xiao, X., & Zhao, X. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02347-3 · Cited by 92 · see citing works
“According to previous studies [2, 23], the diagnoses of CVD, T2D and CKD were ascertained according to the corresponding International Classification of Diseases, 10th Revision (ICD-10) or the Office of Population Censuses and Surveys Classification of Interventions and Procedures, version 4…”
MethodAssociation between systemic immune-inflammation index and cardiovascular-kidney-metabolic syndrome
Gao, C., Gao, S., Zhao, R., Shen, P., Zhu, X., Yang, Y., Duan, C., Wang, Y., Ni, H., Zhou, L., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-69819-0 · Cited by 92 · see citing works
“In this study, it is defined as CMS with concurrent CKD based on its characteristics 14 .”
BackgroundFonarow, G. C., Ahmad, F. S., Ahmad, T. A., Albert, N. M., Alexander, K. M., Baker, W. L., Bozkurt, B., Breathett, K. K., Carter, S. J., Cheng, R. K.-H., et al. (2025) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2025.07.007 · Cited by 99 · see citing works
Obesity and the kidney: mechanistic links and therapeutic advances
Yau, K., Kuah, R., Cherney, D. Z. I., & Lam, T. K. T. (2024) · Nature Reviews Endocrinology · doi:10.1038/s41574-024-00951-7 · Cited by 91 · see citing works
“The term ‘cardiovascular– kidney–metabolic syndrome’ has been defined as a disorder related to the interaction of obesity, diabetes mellitus, CKD and CVD 4 .”
Zheng, G., Jin, J., Wang, F., Zheng, Q., Shao, J., Yao, J., Huang, P., Zhou, H., & Zhou, J. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02589-9 · Cited by 92 · see citing works
Romeo, S., Vidal‐Puig, A., Husain, M., Ahima, R. S., Arca, M., Bhatt, D. L., Diehl, A. M., Fontana, L., Foo, R., Frühbeck, G., et al. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf314 · Cited by 91 · see citing works
“4,142,183,184 UACR and eGFR are essential to the ongoing reassessment of heart and kidney disease risks because risk-modifying therapies are to be initiated or adjusted based on risk status.”
Self-citationCao, Y., Wang, W., Xie, S., Xu, Y., & Lin, Z. (2025) · BMC Public Health · doi:10.1186/s12889-024-21131-2 · Cited by 81 · see citing works
Fan, J., Xu, X., Yang, R.-X., Nan, Y., Wei, L., Jia, J., Zhuang, H., Shi, J., Li, X., Cm, S., et al. (2024) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2024.00311 · Cited by 85 · see citing works
“37 The incidence rates of MetS, T2DM, and CKD in NAFLD patients are higher than in the general population.”
Dong, B., Chen, Y., Yang, X., Chen, Z., Zhang, H., Gao, Y., Zhao, E., & Zhang, C. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02729-1 · Cited by 80 · see citing works
“These conditions play a significant role in the progression of cardiovascular events, especially in individuals with CKM syndrome [1].”
InfluentialPan, H.-C., Chen, J.-Y., Chen, H.-Y., Yeh, F.-Y., Sun, C.-Y., Huang, T. T.-M., & Wu, V.-C. (2024) · Nature Communications · doi:10.1038/s41467-024-50199-y · Cited by 75 · see citing works
Tan, M., Zhang, Y., Zhu, S.-X., Wu, S., Zhang, P., & Gao, M. J. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02689-6 · Cited by 78 · see citing works
“As academic attention to CKM continues to grow, the staging framework for CKM has become more clearly defined, ranging from stage 0 (absence of risk factors) to stage 4 (confirmed CVD) [7].”
InfluentialHu, Y., Yu, L., Li, J., Li, X., Yu, M., & Cui, W. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02593-z · Cited by 74 · see citing works
“As delineated in the AHA Presidential Advisory Statement, the stages of the CKM syndrome range from 0 to 4 [6].”
Cardiovascular-kidney-metabolic syndrome: A step toward multidisciplinary and inclusive care
Claudel, S. E., & Verma, A. (2023) · Cell Metabolism · doi:10.1016/j.cmet.2023.10.015 · Cited by 73 · see citing works
Lu, L., Chen, Y., Liu, B., Li, X., Wang, J., Nie, Z., & Fu, X. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02754-0 · Cited by 71 · see citing works
“First, IR, a core feature of CKM syndrome, leads to elevated blood glucose and triglyceride levels [1].”
InfluentialKhan, S. S., Breathett, K., Braun, L. T., Chow, S. L., Gupta, D. K., Lekavich, C., Lloyd-Jones, D. M., Ndumele, C. E., Rodriguez, C. J., Allen, L. A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001307 · Cited by 75 · see citing works
Self-citationPrioritising the primary prevention of heart failure
Khan, S. S., Berwanger, O., Fiuzat, M., McMurray, J. J. V., Narula, J., Prabhakaran, D., Sliwa, K. S., Tromp, J., & Vaduganathan, M. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01393-5 · Cited by 74 · see citing works
Self-citationTsai, M., Kao, J. T., Wong, C., Liao, C.-T., Lo, W., Chien, K., Wen, C.-P., Wu, K., & Wu, M. (2025) · PLoS Medicine · doi:10.1371/journal.pmed.1004629 · Cited by 78 · see citing works
Liu, K., Hu, J., Huang, Y., He, D., & Zhang, J. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02842-1 · Cited by 68 · see citing works
“Further, the AHA has emphasized that the prevention of cardiovascular events should be prioritized in individuals at CKM stages 0–3 [4].”
Knutson, K. L., Dixon, D., Grandner, M. A., Jackson, C. L., Kline, C. E., Maher, L., Makarem, N., Martino, T. A., St‐Onge, M., & Johnson, D. A. (2025) · Circulation · doi:10.1161/cir.0000000000001388 · Cited by 73 · see citing works
Alicic, R. Z., Neumiller, J. J., & Tuttle, K. R. (2025) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfae212 · Cited by 70 · see citing works
Self-citationHong, J., Zhang, R., Tang, H., Wu, S., Chen, Y., & Tan, X. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02662-3 · Cited by 65 · see citing works
Zheng, Q., Cao, Z., Teng, J., Lü, Q., Huang, P., & Zhou, J. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02742-4 · Cited by 68 · see citing works
“The classification of CKM syndrome stages, which range from 0 to 4, follows the criteria detailed in the AHA Presidential Advisory Statement on CKM Syndrome [28].”
Seligman, H. K., Angell, S. Y., Berkowitz, S. A., Elkind, M. S. V., Hager, K., Moise, N., Posner, H., Muse, J., Odoms‐Young, A. M., Ridberg, R. A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001343 · Cited by 64 · see citing works
Self-citationMutruc, V., Bologa, C., Șorodoc, V., Ceasovschih, A., Morărașu, B. C., Șorodoc, L., Catar, O., & Lionte, C. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14082833 · Cited by 75 · see citing works
“The development of CKM syndrome and the occurrence of associated complications are strongly influenced by an unhealthy lifestyle and neglect of self-care, factors exacerbated by health policies, economic conditions, and unfavorable environmental factors [9].”
InfluentialNdumele, C. E., Rodríguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M. S., Bangalore, S., Bozkurt, B., Breathett, K. K., Clarke, S. L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001453 · Cited by 87 · see citing works
Self-citationMassy, Z. A., & Drüeke, T. B. (2024) · Kidney International Reports · doi:10.1016/j.ekir.2024.05.033 · Cited by 68 · see citing works
Ortíz, A., Guerra, J. M. A., Chan, J. C. N., Jha, V., Kramer, H., Nicholas, S. B., Pavkov, M. E., Wanner, C., Wong, L. P., Cheung, M., et al. (2025) · Kidney International · doi:10.1016/j.kint.2025.04.005 · Cited by 70 · see citing works
Self-citationRanjit Unnikrishnan, I., Shaw, J. E., Chan, J. C. N., Wild, S. H., Peters, A. L., Orrange, S. E., Roden, M., & Mohan, V. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-025-00635-0 · Cited by 60 · see citing works
Li, J., & Wei, X. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.100985 · Cited by 60 · see citing works
“Acknowl-edging this intricate relationship, the AHA introduced a novel framework named cardiovascular-kidney-metabolic (CKM) syndrome, [9] for enhancing multidisciplinary approaches to prevention, risk stratification, and management of these disorders.”
InfluentialBae, J. H. (2025) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2025.0220 · Cited by 72 · see citing works
“Stratification based on CKM profiles may help identify individuals most likely to benefit [83].”
Wang, X., Wen, P., Liao, Y., Wu, T., Zeng, L., Huang, Y., Song, X., Xiong, Z., Deng, L., Li, D., et al. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02784-8 · Cited by 58 · see citing works
“The American Heart Association (AHA) emphasizes that research in populations with CKM syndrome stages 0–3 should focus more on the prevention of CVD onset [2].”
Lichtenstein, A. H., Khera, A., Anderson, C. A. M., Appel, L. J., DeSilva, D. M., Gardner, C. D., Hu, F. B., Jones, D. W., & Petersen, K. S. (2026) · Circulation · doi:10.1161/cir.0000000000001435 · Cited by 60 · see citing works
Self-citationNdumele, C. E., Rodriguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M., Bangalore, S., Bozkurt, B., Breathett, K., Clarke, S. L., et al. (2026) · JACC · doi:10.1016/j.jacc.2026.03.056 · Cited by 90 · see citing works
Self-citationHuang, X., Liang, J., Zhang, J., Fu, J., Xie, W., & Zheng, F. (2024) · Psychological Medicine · doi:10.1017/s0033291724002381 · Cited by 55 · see citing works
Tain, Y., & Hsu, C. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25063298 · Cited by 55 · see citing works
“The growing recognition of pathological links among metabolic risk factors such as obesity and diabetes, cardiovascular disease (CVD), and chronic kidney disease (CKD) has given rise to the conceptualization of cardiovascular–kidney–metabolic (CKM) syndrome [1].”
BackgroundChen, Y., Wu, S., Liu, H., Zhong, Z., Bucci, T., Wang, Y., Zhao, M., Liu, Y., Yang, Z., Gue, Y. X., et al. (2025) · Redox Biology · doi:10.1016/j.redox.2025.103588 · Cited by 55 · see citing works
“As defined by the AHA CKM definition, CKM was categorised into four stages (Supplementary Table S4) [1].”
Miao, H., Wang, K.-E., Li, P., & Zhao, Y. (2025) · Drug Design Development and Therapy · doi:10.2147/dddt.s557114 · Cited by 53 · see citing works
“208 CKM syndrome reflects the interplay among metabolic risk factors, CKD, and CVD and has high morbidity and mortality.”
Chen, Y., Lian, W., Wu, L., Huang, A., Zhang, D., Liu, B., Qiu, Y., & Wei, Q. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02692-x · Cited by 51 · see citing works
“The Cardiovascular-Kidney-Metabolic (CKM) syndrome is an emerging concept that highlights the intricate interplay among metabolic disorder, chronic kidney disease, and cardiovascular disease (CVD) [1].”
Ostrominski, J. W., Claggett, B. L., Miao, Z. M., Causland, F. R. M., Anand, I. S., Desai, A. S., Jhund, P. S., Lam, C. S. P., Pfeffer, M. A., Pitt, B., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.05.005 · Cited by 51 · see citing works
Associations between Class I, II, or III Obesity and Health Outcomes
Yao, Z., Tchang, B. G., Albert, M. H., Blumenthal, R. S., Nasir, K., & Blaha, M. J. (2025) · NEJM Evidence · doi:10.1056/evidoa2400229 · Cited by 50 · see citing works
Xu, Z., Yang, S., Tan, Y., Zhang, Q., Wang, H., Tao, J., Liu, Q., Wang, Q., Feng, W., Li, Z., et al. (2025) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-025-05379-9 · Cited by 57 · see citing works
Prevalence and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in China
Zheng, C., Cai, A., Sun, M., Wang, X., Song, Q., Pei, X., Cao, X., Tian, Y., Lip, G. Y. H., Parati, G., et al. (2025) · JACC Asia · doi:10.1016/j.jacasi.2025.04.007 · Cited by 55 · see citing works
Wu, L., & Huang, Z. (2024) · Scientific Reports · doi:10.1038/s41598-024-82881-y · Cited by 47 · see citing works
Combination therapy as a new standard of care in diabetic and non-diabetic chronic kidney disease
Neuen, B. L., Yeung, E. K., Rangaswami, J., & Vaduganathan, M. (2024) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfae258 · Cited by 48 · see citing works
Self-citationLiu, Y., He, Q., Li, Q., Tian, M., Li, X., Yao, X., He, D., & Deng, C. (2023) · BMC Nephrology · doi:10.1186/s12882-023-03391-z · Cited by 47 · see citing works
“A significant contributor to the CKD burden is hypertension, recognized as a leading risk factor for the development and progression of kidney disease, which was reported affect up to 90% of the population with CKD and accelerating its progression [2, 3].”
BackgroundZhu, R., Wang, R., He, J., Wang, L., Chen, H., Wang, Y., An, P., Li, K., Ren, F., Xu, W., et al. (2025) · The journal of nutrition health & aging · doi:10.1016/j.jnha.2025.100504 · Cited by 45 · see citing works
“Cardiovascular – kidney – metabolic (CKM) syndrome is a novel multi-system disorder defined by the American Heart Association (AHA) [1].”
InfluentialTheodorakis, N., & Nikolaou, M. (2025) · Biomedicines · doi:10.3390/biomedicines13010135 · Cited by 45 · see citing works
Liu, Y., Li, W., Zhou, H., Zeng, H., Jiang, J., Wang, Q., Liu, T., Liu, X., Chen, P., & Zhong, X. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02732-6 · Cited by 44 · see citing works
“For the purpose of staging, very high-risk CKD (stage G4 or G5) and a High 10-year CVD risk predicted by the Framingham Risk Score, were regarded as equivalent factors for the risk of subclinical CVD [7, 20].”
Electronic Health Record Population Health Management for Chronic Kidney Disease Care
Jhamb, M., Weltman, M. R., Devaraj, S. M., Lavenburg, L.-M. U., Han, Z., Alghwiri, A. A., Fischer, G. S., Rollman, B. L., Nolin, T. D., & Yabes, J. G. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.0708 · Cited by 44 · see citing works
Ding, X., Tian, J., Chang, X., Liu, J., & Wang, G. (2025) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwaf248 · Cited by 44 · see citing works
Kalyesubula, R., Aklilu, A. M., Cálice-Silva, V., Kumar, V., & Kansiime, G. (2024) · Kidney360 · doi:10.34067/kid.0000000000000489 · Cited by 45 · see citing works
“39 This is highly important as patients with any stage of CKD are already at a high risk of cardiovascular mortality.”
BackgroundZhang, H., Hu, Z., Wu, J., Li, Y., Jiang, S., Li, J., Wang, X., & Hao, M. (2025) · JACC Asia · doi:10.1016/j.jacasi.2024.12.003 · Cited by 41 · see citing works
Wharton, S., le Roux, C. W., Kosiborod, M., Platz, E., Brueckmann, M., Jastreboff, A. M., Hussain, S. A., Pedersen, S. D., Borowska, L., Unseld, A., et al. (2024) · Obesity · doi:10.1002/oby.24184 · Cited by 40 · see citing works
Self-citationSalerno, P. R. V. D. O., Cotton, A., Elgudin, Y. E., Virani, S. S., Nasir, K., Neeland, I. J., Rajagopalan, S., Sattar, N. A., Al-Kindi, S. G., & Deo, S. V. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.35783 · Cited by 39 · see citing works
Self-citationABCDE to identify and prevent chronic kidney disease: a call to action
Ferro, C. J., Wanner, C., Luyckx, V. A., Stevens, K., Cerqueira, S. A., Darwish, R. A., Fernández‐Fernández, B., Fiel, D., Filev, R., Grieger, M., et al. (2025) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfaf057 · Cited by 41 · see citing works
“Indeed, CKM multimorbidity is becoming increasingly common [3 , 22 , 23 ].”
Zhai, S., Ma, B., Chen, W., & Zhao, Q. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1476029 · Cited by 44 · see citing works
Kim, J.-E., Joo, J., Kuku, K. O., Downie, C. G., Hashemian, M., Powell‐Wiley, T. M., Shearer, J. J., & Roger, V. L. (2025) · The American Journal of Medicine · doi:10.1016/j.amjmed.2025.01.031 · Cited by 39 · see citing works
Self-citationMcClements, L., Kautzky‐Willer, A., Kararigas, G., Ahmed, S. B., & Stallone, J. N. (2025) · Biology of Sex Differences · doi:10.1186/s13293-025-00714-7 · Cited by 40 · see citing works
“As recently outlined by the American Heart Association, individuals living with CKD are amongst the highest risk populations for cardiovascular disease and mortality [111], with the risk increasing exponentially with CKD progression [112].”
Liu, L., Yu, G., Ji, X., Wang, Y., & He, H. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02928-w · Cited by 37 · see citing works
“Multistate Cox regression analyses indicated that all six IR-related indices assessed in this study were significantly associated with the progression of CRM multimorbidity (Tables 3, 4, 5, 6, 7 and 8).”
From Cardiorenal Syndrome to Chronic Cardiovascular and Kidney Disorder
Zoccali, C., Mallamaci, F., Halimi, J., Rossignol, P., Sarafidis, P. A., Caterina, R. D., Giugliano, R. P., & Zannad, F. M. (2023) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.0000000000000361 · Cited by 38 · see citing works
- Authors
- Ndumele, C. E., Rangaswami, J., Chow, S. L., Neeland, I. J., Tuttle, K. R., Khan, S. S., Coresh, J., Mathew, R. O., Baker-Smith, C. M., Carnethon, M. R., Despres, J.-P., Ho, J. E., Joseph, J. J., Kernan, W. N., Khera, A., Kosiborod, M. N., Lekavich, C. L., Lewis, E. F., Lo, K. B., Ozkan, B., Palaniappan, L. P., Patel, S. S., Pencina, M. J., Powell-Wiley, T. M., Sperling, L. S., Virani, S. S., Wright, J. T., Rajgopal Singh, R., Elkind, M. S. V., & on behalf of the American Heart Association
- ORCID
- Ndumele, Chiadi E.
- Rangaswami, Janani
- Chow, Sheryl L.
- Neeland, Ian J.
- Tuttle, Katherine R.
- Khan, Sadiya S.
- Coresh, Josef
- Mathew, Roy O.
- Baker-Smith, Carissa M.
- Carnethon, Mercedes R.
- Ho, Jennifer E.
- Joseph, Joshua J.
- Kernan, Walter N.
- Khera, Amit
- Kosiborod, Mikhail N.
- Lekavich, Carolyn L.
- Lewis, Eldrin F.
- Lo, Kevin B.
- Palaniappan, Latha P.
- Patel, Sonali S.
- Pencina, Michael J.
- Sperling, Laurence S.
- Virani, Salim S.
- Wright, Jackson T.
- Elkind, Mitchell S.V.
- Venue
- Circulation
- Published
- 2023-11-14
- Volume
- 148
- Issue
- 20
- Pages
- 1606-1635
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W4387439311
- Semantic Scholar
- 25267732a9eba1632cae96aae6c92d73078e3163
- Cited by
- 2,208
- References
- 142
- Citations by year
- 2026: 1096 · 2025: 877 · 2024: 215 · 2023: 20
- FWCI
- 79.66
- Type
- journal article
- Language
- en
- Update notices
- correction (2024-03-25)
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Heart Association
- Eli Lilly and Company
- AstraZeneca
- Patient-Centered Outcomes Research Institute
- Emory University
- Health Services Research and Development
- University of Washington
- McGill University
- McGill University Health Centre
- Novo Nordisk
- Agencja Badań Medycznych
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Heart, Lung, and Blood Institute (R01HL140224)
- National Institute of Neurological Disorders and Stroke
- National Center for Advancing Translational Sciences
- Janssen Pharmaceuticals
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- cardiovascular-kidney-metabolic syndrome, chronic kidney disease, metabolic risk factors, cardiovascular disease prevention, cardiovascular mortality, social determinants of health, prediction algorithm, staging, multidisciplinary care, care fragmentation, health equity
- MeSH terms
- American Heart Association, Cardiovascular Diseases, Cardiovascular System, Humans, Kidney, Risk Factors, United States, Metabolic Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
