Implementation Barriers to Evidence-Based Cardiovascular-Kidney-Metabolic Syndrome Management

Area of Science:

• Cardiology
• Nephrology
• Endocrinology
• Public Health

Background:

• Cardiovascular-kidney-metabolic (CKM) syndrome is a newly defined condition linking cardiovascular disease, kidney disease, obesity, and type 2 diabetes.
• CKM syndrome represents a leading cause of global morbidity and mortality, incurring substantial healthcare costs.
• Adverse social determinants of health disproportionately affect individuals with CKM syndrome.

Purpose of the Study:

• To highlight the challenges and barriers hindering the optimal management of CKM syndrome.
• To emphasize the need for a paradigm shift in healthcare approach for CKM syndrome.

Main Methods:

• Review of current evidence on CKM syndrome pathophysiology, risk factors, and treatment outcomes.
• Analysis of barriers to CKM therapy uptake, including system, provider, and patient factors.
• Discussion of the implications for public health policy and clinical practice.

Main Results:

• Despite proven efficacy of cardio-kidney metabolic therapies (e.g., SGLT2 inhibitors, GLP-1 RAs, MRAs), their uptake remains low.
• Significant system barriers (policy, fragmented care, access), provider barriers (awareness, inertia), and patient barriers (social determinants) impede optimal CKM care.
• A substantial economic burden is associated with CKM syndrome, particularly in Australia.

Conclusions:

• A multidimensional, multidisciplinary approach to CKM syndrome care is essential.
• Equitable access to pharmacotherapies for high-risk patient groups is crucial.
• Urgent global action is needed to address this public health emergency and improve CKM syndrome outcomes.