Cardiovascular–Kidney–Metabolic Syndrome Stages, Echocardiographic Characteristics, and Heart Failure Risk: The Atherosclerosis Risk in Communities Study

BACKGROUND: Suboptimal cardiovascular-kidney-metabolic (CKM) health is highly prevalent in the United States, especially among older adults, but whether the CKM syndrome staging framework is predictive of incident heart failure (HF) in this population remains uncertain. METHODS: Participants from the ARIC Study (Atherosclerosis Risk in Communities; visit 5, 2011-2013) who underwent echocardiography were categorized according to the American Heart Association CKM syndrome staging framework, which is based on excess or dysfunctional adiposity, metabolic risk factors, kidney disease, subclinical cardiovascular disease (CVD), and clinical CVD. We evaluated the association between CKM stage and prevalence and progression of cardiac remodeling and longitudinal risk of incident HF. RESULTS: <0.001). CONCLUSIONS: Poor CKM health was widespread among community-dwelling older adults, with higher CKM stage associated with adverse myocardial remodeling and increased risk of incident HF.