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AHA and ACC Release First Ever Cardiovascular-Kidney-Metabolic Syndrome Guideline.

AHA and ACC Release First Ever Cardiovascular Kidney Metabolic Syndrome Guideline.

AHA and ACC Release

A new joint guideline on cardiovascular-kidney-metabolic syndrome establishes a 4-stage classification system and provides recommendations
for prevention and management.

On June 9, 2026, the American College of Cardiology (ACC), American Heart Association (AHA), American Diabetes Association (ADA), and American Society of Nephrology (ASN) issued the first-ever guideline on the prevention and management of cardiovascular-kidney-metabolic (CKM) syndrome in both Circulation and The Journal of the American College of Cardiology.

The new guideline includes details for CKM syndrome staging, as well as recommendations for both clinicians and patients to help identify CKM syndrome risk earlier, prevent CKM syndrome from developing, and provide treatment if it develops. In the US, nearly 90% of adults have at least 1 CKM risk factor, such as obesity, which affects 40% of adults and 21% of children and adolescents.

Authors of the guideline identified 4 stages of CKM syndrome, based on the functioning of the heart, kidneys, and metabolism:

  • Stage 1 includes patients with overweight, obesity, or prediabetes who do not have other metabolic risk factors.
  • Stage 2 includes patients with at least 1 metabolic risk factor and/or kidney disease who do not have cardiovascular disease (CVD).
  • Stage 3 includes patients with asymptomatic CVD and CKM risk factors or patients with the risk equivalents of very-high-risk chronic kidney disease or a high predicted 10-year risk for cardiovascular disease.
  • Stage 4 includes patients with diagnosed CVD and overweight or obesity, kidney disease, or other metabolic risk factors.

A key highlight of the guideline is the improvement of risk assessment via use of the Predicting Risk of Cardiovascular Disease Events (PREVENT™) equations. The PREVENT equations should be used to estimate 10- and 30-year risk for CVD to provide guidance for developing individualized lifestyle and treatment plans. The guideline authors recommend using the PREVENT equations because they include metabolic and kidney factors and are more precise and comprehensive compared with previous cardiovascular risk estimation tools.

This guideline calls for earlier screening and care, focusing on prevention and coordinated action to reduce the risk of cardiovascular disease before serious complications develop or a major cardiac event occurs.
The guideline also includes a recommendation for screening for social factors that affect health to help identify patients with elevated risk for CKM syndrome. These social factors include financial strain, food insecurity, and housing instability.

Additionally, the guideline authors emphasize the importance of healthy lifestyle behaviors and coordinated interdisciplinary care for preventing and managing CKM syndrome. Patients should be encouraged to follow the AHA’s Life’s Essential 8 to improve or maintain healthy nutrition, weight, physical activity levels, blood pressure, blood glucose, and cholesterol.

Patients for whom treatment options beyond lifestyle modifications are indicated, the guideline indicates initiating medications for managing blood pressure, blood glucose, cholesterol, and/or weight. In select patients with type 2 diabetes or obesity and other CVD risk factors, glucagon-like peptide (GLP)-1-based therapies are recommended. The guideline authors also note that bariatric and metabolic surgeries may be considered as treatment options for CKM syndrome.

“This guideline calls for earlier screening and care, focusing on prevention and coordinated action to reduce the risk of cardiovascular disease before serious complications develop or a major cardiac event occurs,” said Chiadi E. Ndumele, MD, PhD, MHS, FAHA, chair of the guideline writing committee and the director of obesity and cardiometabolic research at Johns Hopkins School of Medicine in Baltimore, in a news release.

This article originally appeared on The Cardiology Advisor