Nearly 90% of U.S. Adults have at least one risk factor for cardiovascular-kidney-metabolic (CKM) syndrome, a newly defined health condition encompassing heart disease, kidney disease, diabetes, and obesity, according to a recent American Heart Association survey released October 20, 2025.
Despite the widespread prevalence of CKM syndrome, the same survey found that approximately 9 in 10 U.S. Adults are unaware of the condition, though a significant majority – nearly 75% – expressed interest in learning more. This lack of awareness occurs as research increasingly demonstrates the interconnectedness of these conditions and the potential for reversible outcomes.
The American Heart Association launched the CKM Health Initiative in 2024, a four-year program designed to improve care coordination and empower patients in managing their health. The initiative follows a 2023 presidential advisory that formally defined CKM Syndrome, recognizing it as a systemic disorder rather than a collection of separate illnesses.
According to a study published in November 2025 in PubMed, approximately 90% of U.S. Adults are affected by CKM syndrome, stemming from a combination of metabolic dysfunction, chronic kidney disease, and cardiovascular disease. The study, which utilizes a staging framework developed by the American Heart Association in 2023, categorizes the syndrome from stage 0 (no risk factors) to stage 4 (clinical cardiovascular disease with persistent metabolic dysfunction). Progression through these stages is linked to incrementally higher cardiovascular mortality risk.
Niloofar Nobakht, MD, an associate clinical professor of nephrology at the David Geffen School of Medicine at UCLA, has proposed a wellness plan, termed “The Seven Ws of Wellness,” to address CKM syndrome and improve overall health. The plan focuses on seven core lifestyle pillars: Water Intake, Weight, What to Eat, Wake & Sleep Hygiene, Walk & Function Out, Worry (Stress Management), and Waltz (Music & Joy).
Dr. Nobakht emphasizes the importance of adequate hydration, noting that the brain, heart, and kidneys are heavily reliant on water intake. She suggests replacing sugar-added beverages with water to improve calorie intake and metabolic health. Regarding weight, Dr. Nobakht advocates focusing on body composition – the ratio of muscle to fat – rather than solely on body weight, suggesting the leverage of advanced scales to track these metrics.
Dietary recommendations center around whole, fiber-rich foods, with a reduction in processed sugars. Dr. Nobakht recommends dietary approaches like the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diets, which have been shown to improve brain, heart, and kidney health, lower blood pressure, and improve lipid profiles.
Sleep hygiene, including consistent sleep-wake rhythms and quality sleep, is also crucial, supporting hormonal balance, metabolic health, and emotional well-being. Dr. Nobakht advises establishing a fixed wake-up time, maximizing morning sunlight exposure, and avoiding caffeine or alcohol late in the evening.
Regular physical activity, even light or moderate exercise like brisk walking for 15-20 minutes daily, is recommended to optimize metabolic, brain, cardiovascular, and kidney health. Dr. Nobakht notes that exercise improves mood, mental clarity, and can lower resting heart rate and blood pressure.
Stress management, through practices like meditation, yoga, and mindfulness, is also a key component of the plan. Dr. Nobakht highlights the positive impact of mindfulness on the autonomic nervous system and its potential to improve glycemic control and reduce inflammation in individuals with metabolic abnormalities.
Finally, Dr. Nobakht stresses the importance of engaging in joyful activities, particularly music, to enhance mood, reduce stress, and strengthen brain-body connections. She cites research suggesting that listening to music can positively influence cardiovascular physiology by modulating the autonomic nervous system.
Dr. Nobakht believes that the interconnectedness of these seven pillars reinforces their individual benefits, collectively impacting body weight, muscle health, blood glucose, blood pressure, and overall vital organ health.
