Lifestyle Interventions in Cardiovascular-Kidney-Metabolic Syndrome JACC: Advances Expert Panel

Cardiovascular-kidney-metabolic (CKM) syndrome impacts nearly all organ systems, with progressive dysfunction leading to morbidity and mortality. The high burden of CKM syndrome requires accessible, scalable, and low-cost interventions to prevent downstream complications. Nonpharmacologic interventions targeting lifestyle factors, such as diet, physical activity, and behavioral modification, represent the cornerstone of CKM syndrome management to prevent a progressive disease and associated adverse outcomes. Lifestyle interventions play a key role not only in primordial and primary prevention in the earlier stages of CKM syndrome (stages 0-2) but also in subclinical cardiovascular disease (stage 3) as well as prevalent cardiovascular disease (stage 4). The purpose of the present review is to describe the evidence from randomized clinical trials for specific lifestyle interventions across CKM syndrome stages. This review will explore the impact of lifestyle interventions in each CKM syndrome stage and how they impact interrelated systems.