The American Heart Association and the American College of Cardiology have published the first-ever clinical guideline for cardiovascular-kidney-metabolic syndrome, or CKM syndrome, reframing excess weight, particularly abdominal fat, as a key driver of the condition. The guideline, released on June 9, 2026, aims to raise awareness of the interconnection between heart disease, kidney disease, and metabolic conditions such as diabetes and obesity, and calls on healthcare professionals to initiate early, prevention-focused conversations about weight.
Nearly 9 in 10 U.S. adults have at least one condition within CKM syndrome, including high blood pressure, abnormal cholesterol, high blood glucose, reduced kidney function, or excess weight, according to the guideline. As obesity rates continue to rise, the guideline underscores the importance of supporting a healthy weight to prevent future health problems. “In terms of CKM health, weight is not just about a number on a scale — people with the same body weight can have very different health profiles,” said Dr. Chiadi E. Ndumele, chair of the writing committee. “Rather, what’s most important is how fat tissue affects your metabolic health.”
The guideline replaces the 2013 guideline for managing overweight and obesity. CKM syndrome was first defined by the American Heart Association in 2023. Dr. Ndumele highlighted that many patients may not realize how closely conditions like heart disease, kidney disease, and diabetes are connected, and that having one increases the risk of others. The guideline aims to help clinicians from various specialties speak a common language regarding weight management and its clinical consequences.
Excess abdominal fat can cause inflammation, leading to insulin resistance and vascular problems, which can progress to diabetes, kidney disease, heart failure, or stroke. However, if caught early, the disease process can be stopped or reversed. The guideline provides strategies for non-judgmental discussions about weight, beginning with questions like, “Is now a good time for us to address your weight and your health?”
Coordinated care is a key emphasis. The guideline recommends using navigators or care coordinators to improve communication between patients, primary care providers, and specialists. “People with CKM syndrome don’t experience one condition at a time — it often all hits at the same time,” said Dr. Fatima Rodriguez, vice-chair of the writing committee. The guideline also highlights the use of effective medications such as SGLT2 inhibitors, GLP-1 based therapies, and nonsteroidal mineralocorticoid receptor antagonists, which benefit multiple body systems.
The American Heart Association launched the CKM Health Initiative in 2024 to improve diagnosis and treatment. More information is available on the initiative’s page at heart.org. The full guideline is published in Circulation.
