Your Heart's Hidden Connections: Why Doctors Are Looking Beyond the Heart to Prevent Disease

Heart disease doesn't always start in the heart—and that's the critical insight millions of Americans are missing. According to the American Heart Association's 2026 statistics update, diabetes and kidney disease are major risk factors for heart disease, yet many cases go completely undiagnosed. The connection is so significant that doctors now use a term to describe it: cardiovascular-kidney-metabolic (CKM) syndrome, which links heart health, kidney function, and how your body manages energy and weight.

What Is Cardiovascular-Kidney-Metabolic Syndrome?

CKM syndrome represents the interconnected nature of three seemingly separate health conditions. When you have one of these conditions—diabetes, kidney disease, or heart disease—your risk of developing the others increases dramatically because they share common risk factors. "We are encouraging people to become aware of the connection between conditions so they and their health care team can think about their overall health beyond individual conditions," said Dr. Stacey E. Rosen, volunteer president of the American Heart Association. "Understanding the connection helps you better prevent complications through lifestyle changes and appropriate treatment."

The statistics are sobering. Almost 1 in 4 U.S. adults with diabetes don't even know they have it, and as many as 9 in 10 adults with chronic kidney disease are unaware of their condition. This lack of awareness is particularly dangerous because these conditions often develop silently, with few or no early symptoms.

Why Kidney Disease Screening Is Being Overlooked?

One of the biggest gaps in preventive care involves kidney disease screening. According to the American Heart Association, two-thirds of patients with high blood pressure or diabetes are unaware they also have kidney disease—largely because they haven't received a specific urine test called uACR (urine albumin-to-creatinine ratio). This is a critical oversight because kidney function directly influences cardiovascular risk.

For people with diabetes or high blood pressure, two screening tests for kidney health are recommended:

• uACR Urine Test: Measures protein levels in urine, which can indicate early kidney damage before symptoms appear
• eGFR Blood Test: Estimates how well your kidneys filter waste from your blood, providing a different but complementary measure of kidney function
• Blood Pressure Monitoring: High blood pressure damages both heart and kidney function, making regular checks essential for early detection

What Should You Be Screened For?

The American Heart Association recommends comprehensive screening that goes well beyond a single blood pressure check. A complete CKM syndrome screening includes several key measurements that work together to reveal your overall cardiovascular and metabolic health:

• Blood Pressure: Optimal is below 120/80 millimeters of mercury, though your doctor may set different targets based on your individual health profile
• Cholesterol Panel: Includes total cholesterol, LDL cholesterol (the "bad" kind that builds up in arteries), HDL cholesterol (the "good" kind that helps remove bad cholesterol), and triglycerides (the most common type of fat in your blood)
• Blood Glucose Levels: Measured either as fasting glucose (short-term) or A1C (long-term average blood sugar over three months)
• Body Measurements: Body mass index (BMI) and waist circumference, which indicate whether excess weight is contributing to metabolic problems
• Kidney Function Tests: Both uACR and eGFR tests to catch kidney disease early

Once you have these results, a healthcare professional can use the PREVENT online calculator—developed by researchers at Northwestern University—to estimate your individual risk for cardiovascular disease over the next 10 or 30 years. This tool represents a major advance in preventive medicine because it helps identify people who would benefit from earlier interventions before a heart attack or stroke occurs.

How Accurate Are These New Risk Prediction Tools?

The PREVENT calculator was developed specifically to predict cardiovascular disease risk more accurately than older models. In a study published in Nature Medicine, researchers tested PREVENT on data from more than 2.5 million U.S. veterans between ages 30 and 79 who had no history of cardiovascular disease or kidney failure. The tool performed well across all racial and ethnic groups—Asian/Native Hawaiian/Pacific Islander, Hispanic, non-Hispanic Black, and non-Hispanic white populations—and estimated cardiovascular disease risk more accurately than the current standard of care.

Another version of PREVENT helps younger adults understand their long-term risk. Researchers analyzed nearly 8,700 U.S. adults aged 30 to 59 and found that on average, women had a "heart age" of 55.4 years compared to their actual age of 51.3 years, while men showed an even larger gap with a heart age of 56.7 compared to an actual age of 49.7 years. This means many younger people's hearts are aging faster than their bodies—a wake-up call that preventive action is needed now, not later.

"If a healthcare clinician can use models like PREVENT to predict which patients are more likely to develop cardiovascular disease, including heart failure, then they can emphasize preventive lifestyle measures, such as structured exercise programs, or consider medications such as GLP-1 receptor agonist medications earlier to potentially improve cardiovascular outcomes in their patient," explained Dr. Sadiya Khan, Magerstadt Professor of Cardiovascular Epidemiology at Northwestern University.

The Good News: CKM Syndrome Is Preventable

Despite these alarming statistics, the American Heart Association emphasizes that approximately 80% of heart attacks and strokes are preventable. The key is catching risk factors early through screening and then taking action through lifestyle changes and, when appropriate, medication.

Healthy habits aligned with the American Heart Association's "Life's Essential 8" can improve multiple health conditions simultaneously. These include eating a diet rich in vegetables and lean or plant-based proteins like beans, chicken, and fish while limiting red meat, processed foods, sugary sweets, and fried foods. You should aim for 150 minutes of moderate exercise (like brisk walking or light weight training) or 75 minutes of strenuous exercise (like running or heavy lifting) per week, get 7 to 9 hours of quality sleep nightly, maintain a healthy weight, manage blood sugar levels, and keep cholesterol in check.

The current statistics show that about half of all U.S. adults have high blood pressure, about 1 in 3 has high total cholesterol, more than half have prediabetes or diabetes, over half have a high waist circumference, and about 1 in 7 has kidney disease. These numbers suggest that nearly everyone could benefit from CKM syndrome screening—not just those with obvious symptoms.

The takeaway is straightforward: your heart doesn't work in isolation. By understanding the connections between your heart, kidneys, and metabolic health, and by getting screened for all three, you and your doctor can identify risks early and take action to prevent disease before it develops. Talk to your healthcare provider about getting screened for CKM syndrome today.