Association between cardiovascular-kidney-metabolic health metrics and long-term cardiovascular risk: Findings from the Chinese Multi-provincial Cohort Study.
10.1097/CM9.0000000000003752
- Author:
Ziyu WANG
1
;
Xuan DENG
2
;
Zhao YANG
1
;
Jiangtao LI
1
;
Pan ZHOU
1
;
Wenlang ZHAO
1
;
Yongchen HAO
1
;
Qiuju DENG
1
;
Na YANG
1
;
Lizhen HAN
1
;
Yue QI
1
;
Jing LIU
1
Author Information
1. Epidemiology Branch, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing 100029, China.
2. Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China.
- Publication Type:Journal Article
- Keywords:
Cardiovascular disease;
Cardiovascular-kidney-metabolic health;
Chronic kidney disease;
Cohort study;
Long-term CVD risk;
Metabolic disorder
- MeSH:
Humans;
Female;
Male;
Cardiovascular Diseases/etiology*;
Middle Aged;
Adult;
Cohort Studies;
Renal Insufficiency, Chronic/metabolism*;
Aged;
Risk Factors;
Metabolic Syndrome/metabolism*;
China;
East Asian People
- From:
Chinese Medical Journal
2025;138(17):2139-2147
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The American Heart Association (AHA) introduced the concept of cardiovascular-kidney-metabolic (CKM) health and stage, reflecting the interaction among metabolism, chronic kidney disease (CKD), and the cardiovascular system. However, the association between CKM stage and the long-term risk of cardiovascular disease (CVD) has not been validated. This study aimed to evaluate the long-term CVD risk associated with CKM health metrics and CKM stage using data from a population-based cohort study.
METHODS:In total, 5293 CVD-free participants were followed up to around 13 years in the Chinese Multi-provincial Cohort Study (CMCS). Considering the pathophysiologic progression of CKM health metrics abnormalities (comprising obesity, central adiposity, prediabetes, diabetes, hypertriglyceridemia, CKD, and metabolic syndrome), participants were divided into CKM stages 0, 1, and 2. The time-dependent Cox regression models were used to estimate the cardiovascular risk associated with CKM health metrics and stage. Additionally, broader CVD outcomes were examined, with a specific assessment of the impact of stage 3 in 2581 participants from the CMCS-Beijing subcohort.
RESULTS:Among participants, 91.2% (4825/5293) had at least one abnormal CKM health metric, 8.8% (468/5293), 13.3% (704/5293), and 77.9% (4121/5293) were in CKM stages 0, 1, and 2, respectively; and 710 incident CVD cases occurred during a median follow-up time of 13.3 years (interquartile range: 12.1 to 13.6 years). Participants with each poor CKM health metric exhibited significantly higher CVD risk. Compared with stage 0, the hazard ratio (HR) (95% confidence interval [CI]) for CVD incidence was 1.31 (0.84-2.04) in stage 1 and 2.27 (1.57-3.28) in stage 2. Significant interactive impacts existed between CKM stage and age or sex, with higher CVD risk related to increased CKM stages in participants aged <60 years or females.
CONCLUSION:These findings highlight the contribution of CKM health metrics and CKM stage to the long-term risk of CVD, suggesting the importance of multi-component recognition and management of poor CKM health in CVD prevention.
