Coughlin et al. Cardiovascular Medicine 2026.pdf

Because CKMS was only proposed by the American Heart Association in 2023, there has been a paucity
of information about the distribution and determinants of the syndrome across population groups. We
reviewed published studies of the prevalence of CKMS in the U.S. and other countries and obtained
new estimates of the prevalence of this syndrome among U.S. adults by birth decade and
sociodemographic attributes using 2019, 2021, and 2023 Behavioral Risk Factor Surveillance System
(BRFSS) data. The results of this study indicate that CKMS is widespread in the general U.S.
population, especially among older cohorts born before 1940 and during the 1940s, 1950s, and 1960s.
Except for the three younger cohorts, born in the 1980s, 1990s, and 2000 or later, the prevalence
of CKMS stage 4 was significantly higher among males than in females. Among those born between the
1950s and 1990s, the prevalence was significantly higher among non-Hispanic Blacks compared to
their non-Hispanic white counterparts. Across all birth decades, prevalence of CKMS stage 4 was
generally higher among those without a college degree, from a low-income household, and residing in
rural areas. These prevalence rate estimates will further our understanding of the burden and
unique needs of different population groups in improving cardiovascular–kidney–metabolic health
across the life course.