While you may be tracking your blood sugar, worrying about your cholesterol, or trying to lose weight, what happens if all these seemingly different health issues are actually the warning signs of a single health issue? In what is touted as a landmark, first-of-its-kind study, health experts from the American Heart Association and the American College of Cardiology have launched a new joint guideline on cardiovascular-kidney-metabolic syndrome, or CKM syndrome.
The guidelines issued in June 2026 note that higher stages of CKM syndrome are associated with a “greater burden of serious health conditions, such as Type 2 diabetes, chronic kidney disease, and a higher risk of cardiovascular disease and mortality”.
“Heart, kidney, and metabolic conditions don’t occur in isolation—they are deeply connected,” said Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA, chair of the guideline writing committee and the director of obesity and cardiometabolic research at Johns Hopkins School of Medicine in Baltimore in the US, in a statement.
After reviewing risk factors “including overweight/obesity, pre-diabetes/Type 2 diabetes, high blood pressure and abnormal lipids, as well as chronic kidney disease”, the guideline emphasises comprehensive recommendations including “screening, prevention and treatment for people with or at risk of developing CKM syndrome”. This includes healthy lifestyle behaviours; medications, including GLP-1-based therapies and SGLT2 inhibitors; and/or metabolic and bariatric surgery, when appropriate.
To learn more, we reached out to medical experts.
How can preventive strategies help? (Photo: AI Generated)
Dr Parin Sangoi, consultant, interventional cardiologist, Wockhardt Hospitals, Mumbai Central, said CKM syndrome is a “newly recognised condition that shows how closely related the heart, kidneys, and metabolism are”. “Issues like obesity, diabetes, high blood pressure, and kidney disease are connected and do not happen in isolation. When one system is affected, it often puts stress on the others. The importance of CKM syndrome is in spotting these related risks early, before they lead to a heart attack, stroke, heart failure, or kidney failure,” elucidated Dr Sangoi.
Dr Aseem Thamba, consultant nephrologist and kidney transplant physician, Zen Multi-speciality Hospital Chembur, said CKM highlights a “strong connection between heart disease, kidney disease, diabetes, obesity, and metabolic disorders“. “These conditions often develop together and can worsen one another over time. For example, uncontrolled diabetes or obesity can damage both the heart and kidneys, while kidney disease can further increase the risk of cardiovascular complications,” explained Dr Thamba.
The guidelines are important because they encourage doctors and patients to look at overall health rather than treating each condition separately, Dr Thamba added.
What’s the focus on?
The focus is on early identification of risk factors such as excess weight, high blood pressure, abnormal cholesterol levels, elevated blood sugar, and reduced kidney function before serious complications occur. “People should pay attention to warning signs such as persistent fatigue, swelling in the feet, unexplained weight gain, shortness of breath, frequent urination, high blood pressure, or abnormal blood sugar levels,” said Dr Thamba.
What are the stages of CKM syndrome, and what should people look out for?
Stage 1: This is the earliest stage. A person may be overweight, obese, or have prediabetes. “Most people feel completely normal and may not show any obvious symptoms. This stage is often overlooked because the warning signs are subtle,” said Dr Sangoi.
Stage 2: Risk factors become more noticeable. “High blood pressure, abnormal cholesterol levels, Type 2 diabetes, or early kidney disease may develop. Symptoms can include fatigue, increased thirst, frequent urination, unexplained weight changes, or consistently high blood pressure readings,” said Dr Sangoi.
Stage 3: Dr Sanhoi said that damage to the heart or blood vessels may already have begun, even though symptoms are often absent. Some people may notice reduced exercise capacity, breathlessness during exertion, or chest discomfort. Regular health screenings become important at this stage.
Stage 4: This is the most advanced stage, where cardiovascular disease is already present. “Individuals may have suffered a heart attack, stroke, heart failure, atrial fibrillation, or peripheral artery disease. Symptoms can include chest pain, breathlessness, swelling of the legs, palpitations, or decreased daily functioning,” described Dr Sangoi.
What to note?
However, many individuals may not experience noticeable symptoms in the early stages, making regular health check-ups essential. CKM syndrome does not develop overnight, doctors asserted.
“It progresses slowly over the years. The good news is that early stages can often be slowed, stopped, or even reversed with healthy eating, regular exercise, weight management, enough sleep, and timely control of blood pressure, blood sugar, and cholesterol. The sooner the risk factors are identified, the better the chances of protecting heart and kidney health in the long run,” said Dr Sangoi.
What's driving your metabolic issues? (Photo: AI Generated) 
How can preventive strategies help? (Photo: AI Generated)
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