Millions of women may be unknowingly living with health risks tied to the complex interaction between the heart, kidneys, and metabolism. This dangerous interplay, known as cardiovascular-kidney-metabolic (CKM) syndrome, significantly increases the likelihood of developing cardiovascular disease—the leading cause of death among women worldwide.
Understanding CKM Health
CKM health refers to the interconnectedness of cardiovascular (heart), kidney, and metabolic functions. Key CKM health factors include:
- Blood pressure
- Cholesterol
- Body weight
- Blood glucose (sugar)
- Kidney function
When one of these systems becomes impaired, it can trigger negative effects in the others. Over time, this imbalance may lead to CKM syndrome, which elevates the risk of severe cardiovascular events.
Recognizing this critical health issue, the American Heart Association (AHA), supported by Novo Nordisk, Boehringer Ingelheim, and DaVita, has launched a CKM health initiative to improve awareness, prevention, and treatment.
1. Know Your Greatest Health Risk
Cardiovascular disease is the top health threat facing women, yet many are unaware of their risk. Statistics from the AHA reveal:
- Nearly 45% of women aged 20 or older are living with some form of cardiovascular disease.
- 1 in 3 women will die from cardiovascular disease.
Dr. Sadiya S. Khan, a volunteer with the AHA and professor of cardiovascular epidemiology at Northwestern University, highlights a gender gap in awareness: “Despite heart disease being the leading cause of death for women, most are not aware of their risk.”
Women often experience different heart disease symptoms than men. For instance, while chest pain is the most common symptom of a heart attack, women may also feel pain in the arms, jaw, neck, or upper back. This makes early detection especially challenging.
2. Take Action Early
When risk factors accumulate, the danger to heart health increases exponentially. Women with either Type 2 diabetes or chronic kidney disease are expected to reach high risk for heart disease 8–9 years earlier than those without these conditions. For women with both conditions, the risk escalates up to 26 years earlier.
This underscores the importance of monitoring and addressing CKM health throughout a woman’s lifetime—not just in later years.
3. Know Your Interconnected Risk Factors
Many people with high blood pressure or diabetes are unaware they are also at risk for kidney disease. This is because early kidney issues typically do not present symptoms. Proper screening is essential and includes:
- Urine albumin-to-creatinine ratio (UACR): detects protein in urine
- Estimated glomerular filtration rate (eGFR): measures kidney function
Dr. Khan emphasizes: “Knowing your health numbers is critical to optimize your CKM health and prioritize prevention.”
Recommended CKM Health Targets for Women
| Health Indicator | Recommended Level |
|---|---|
| Blood pressure | Below 120/80 mm Hg |
| Triglycerides | Below 135 mg/dL |
| HDL cholesterol | Above 50 mg/dL |
| Waist circumference | Below 35 inches (31 inches for Asian women) |
| Body Mass Index (BMI) | Below 25 kg/m² (23 kg/m² for Asian women) |
| Fasting blood glucose | 70–99 mg/dL |
| A1C (blood sugar control) | Below 5.7% |
| UACR | Below 30 mg/g |
| eGFR | 90 mL/min/1.73 m² or higher |
A disruption in one area often leads to abnormalities in others. Encouragingly, improving even one health factor can positively impact the rest.
4. Pregnancy and Menopause Influence CKM Health
Both pregnancy and menopause play major roles in shaping a woman’s long-term CKM health.
Pregnancy and Future Risk
“Each pregnancy is a window into later heart, kidney, and metabolic health,” says Dr. Janani Rangaswami, a professor of medicine at George Washington University and co-chair of the AHA’s CKM scientific advisory group.
Complications during pregnancy—such as preeclampsia, gestational diabetes, and gestational hypertension—can significantly raise the risk of developing:
- Chronic kidney disease
- Type 2 diabetes
- Cardiovascular disease
Therefore, women planning a pregnancy are urged to optimize their heart and metabolic health in advance.
Menopause and Metabolic Changes
Menopause marks another critical health shift. Declining estrogen levels are accompanied by:
- Increased abdominal fat
- Elevated cholesterol levels
- Stiffening of blood vessels
Early menopause (before age 45) is associated with a higher risk of kidney disease, metabolic disorders, and cardiovascular issues.
5. Social and Economic Factors Affect Women Differently
Social determinants of health—such as financial hardship, neighborhood safety, and access to healthy foods—significantly influence CKM health. For women, these factors present unique challenges:
- Marriage may correlate with worse health outcomes for women.
- Cost-related care delays are more common among women than men.
- Underrepresentation in research and dismissal of symptoms often hinder women’s access to appropriate care.
Dr. Khan notes: “Women may be less likely to receive evidence-based treatment and more likely to be misdiagnosed.”
For example, symptoms like shortness of breath or nausea during a heart attack may be misattributed to anxiety in women.
Be Your Best Advocate
Both Khan and Rangaswami encourage women to take charge of their health by:
- Tracking health metrics regularly
- Requesting thorough screenings
- Including pregnancy history on medical forms
- Seeking care for menopause symptoms
“Sometimes being your best advocate is your best bet,” Khan concludes. “Empower yourself to talk openly with healthcare providers about your heart, kidney, and metabolic health.”
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