Ever Heard of CKM? Chances Are Good You Have It!

I would be willing to bet a week’s salary that you have never heard of CKM. A lot of healthcare professionals probably don’t know much about it either. CKM stands for cardiovascular-kidney-metabolic syndrome. It’s hardly any wonder that this “new” health condition is not a household name. The American Heart Association (AHA) only came up with it two years ago. It is a term that refers to a constellation of disorders including chronic kidney disease, high blood pressure, elevated cholesterol and blood sugar levels, and overweight. Some very big drug companies are supporting the AHA’s “new” syndrome.

A survey conducted by the AHA found that:

“About 9 in 10 U.S. adults have not heard of cardiovascular-kidney-metabolic (CKM) syndrome, a newly defined health condition affecting nearly 90% of adults…”

Do Almost ALL Americans have CKM?

The only way you could escape a diagnosis of CKM is if your body mass index (BMI) is between 18.5 and 24.9, your blood pressure is under 120/80, your LDL cholesterol is below 100, your fasting blood glucose is less than 100 mg/dL and you have a glomerular filtration rate (GFR) of 60 or above.

Given those numbers, I would estimate that very few Americans would be considered healthy by the AHA. I would go further, though. I would bet that only a tiny number, less that 5% of American adults would be able to avoid a diagnosis of CKM.

Is it healthy for more than 90% of Americans to think of themselves as seriously ill? The American Heart Association seems to think so. I have my doubts. When people are told that they have a chronic health condition that might lead to an early demise, it just might make them a bit anxious or depressed.

Labeling People “Hypertensive” Can Have Negative Consequences:

Here is an article from the Journal of Psychosomatic Research, Feb. 15, 2013:

“Observational studies of ‘hypertension labeling’ have demonstrated a broad range of negative outcomes among patients who are aware of their hypertension status compared with those who are hypertensive but unaware of the diagnosis. Increases in work absenteeism, higher levels of physical symptoms and distress, and lower health-related quality of life have been reported, and are not explained by BP elevation itself or by drug treatment, suggesting that psychological effects of being labeled likely play a significant role.”

That’s “just” hypertension. Telling people that they are on the road to heart disease, diabetes and/or kidney disease is likely to create a lot of worry. And of course the answer will almost always be to take more drugs.

A CKM Label Is Likely to Lead to Drugs:

When people are told that their blood pressure is above 120/80 or their “bad” cholesterol is over 100, they almost inevitably are advised to take additional medications. That’s because very few people can get their LDL cholesterol under 100 without a statin or some other cholesterol-lowering medicine.

During the course of a stressful day, many people will have a blood pressure reading over 120/80 at some point or another. Just driving to the doctor’s office can be stressful. And do not get me started describing the many ways clinicians take blood pressure readings incorrectly! Here is a link to common mistakes made when blood pressure is measured at a clinic or doctor’s office.

Would you be surprised to learn that key pharmaceutical companies are sponsoring the AHA’s cardiovascular-kidney-metabolic syndrome Health Initiative program?

Here is the AHA’s tip of the hat to its benefactors:

“The American Heart Association’s Cardiovascular-Kidney-Metabolic Health Initiative is made possible by Founding Sponsors Novo Nordisk® and Boehringer Ingelheim, Supporting Sponsors Novartis Pharmaceuticals Corporation and Bayer, and Champion Sponsor DaVita®.”

The more people diagnosed with obesity, chronic kidney disease, high blood pressure, elevated cholesterol and blood sugar levels, the more medicines doctors will prescribe.

One Benefit of the AHA’s Initiative Around CKM:

One of the goals of the American Heart Association’s CKM Health Initiative is to break down some traditional silos in medicine. In the case of cardiovascular-kidney-metabolic syndrome you have cardiologists dealing with the heart and blood vessels, the nephrologists are handling kidney problems and endocrinologists are managing blood glucose and metabolism issues.

You can read about the Silo challenge in medicine in this article. The problem is that no one doctor is coordinating care from all the specialists. Imagine a football team with lots of “specialists.” There is the center, wide receivers, the punter and running backs to name just a few of the “specialists” on every team. Without a quarterback calling the plays and coordinating the action, however, there would be chaos!

There is a lot of chaos in medicine. Not all the specialists who handle cardiovascular-kidney-metabolic syndrome are communicating with one another. The AHA wants patients and physicians to recognize that this condition is not a cluster of different conditions. Rather, it wants a team approach that will allow for a coordinated treatment program.

If the AHA were to help initiate nondrug approaches to weight management and support food as medicine, social support and exercise programs, we would be a lot more enthusiastic about its CKM diagnosis. I am not just referring to words. A lot of health professionals talk a good game about “eating healthy” and exercising. But talk is cheap. Until the AHA puts some real clout behind such nondrug programs, we remain skeptical that diagnosing over 90% of the American public with life-threatening health conditions is likely to make America healthier.

Please share your thoughts about the “new” cardiovascular-kidney-metabolic syndrome in the comment section below.