Diabetes and kidney disease are major risk factors for heart disease, yet many cases remain undiagnosed, according to the American Heart Association's new 2026 statistics update. A consumer survey conducted last fall revealed that most people do not realize their heart, kidney, and metabolic health are interconnected, a condition medically termed cardiovascular-kidney-metabolic syndrome, or CKM syndrome.
The Association's report indicates nearly one in four U.S. adults with diabetes are unaware they have it, while Centers for Disease Control data show as many as nine in ten adults with chronic kidney disease do not know they have it. Because these conditions are closely linked, having one often increases the likelihood of developing the others due to shared risk factors including high blood pressure, high cholesterol, high blood sugar, excess weight, and reduced kidney function.
"We are encouraging people to become aware of the connection between conditions so they and their health care team can think about their overall health beyond individual conditions," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "Understanding the connection helps you better prevent complications through lifestyle changes and appropriate treatment."
Screening for kidney disease in particular could be improved, as two-thirds of patients with high blood pressure or diabetes are not aware they also have kidney disease due to lack of uACR testing, a urine test for kidney function. For people with diabetes or high blood pressure, two screening tests for kidney health are suggested: the uACR urine test and eGFR blood test, each measuring different aspects of kidney health and function.
Regular screening of cardiovascular, kidney, and metabolic health can catch problems early, as approximately 80% of heart attacks and strokes are preventable, according to the American Heart Association. Risk factors often develop slowly with few or no symptoms initially. "Due to the current risk factor rates, everyone could benefit from being screened this way," Rosen added.
The Association's 2026 statistics report shows about half of all U.S. adults have high blood pressure, about one in three has high total cholesterol, more than half have prediabetes or diabetes, over half have a high waist circumference, and about one in seven has kidney disease. Screening for CKM syndrome may include tests for blood pressure, cholesterol panel, blood glucose, body weight and size measured by BMI and waist circumference, and kidney function measured with both UACR and eGFR.
A healthcare professional can put results from these tests into the PREVENT online calculator to estimate individual risk for cardiovascular disease over the next 10 or 30 years. CKM syndrome is preventable and treatable through healthy habits like those in Life's Essential 8 and evidence-based treatments that can improve multiple health conditions together.
The American Heart Association's Cardiovascular-Kidney-Metabolic Health Initiative is a specific effort to raise awareness of the connections between CKM syndrome conditions and improve diagnosis rates. Supported by founding sponsors Novo Nordisk and Boehringer Ingelheim, with supporting sponsors Novartis Pharmaceuticals Corporation and Bayer, and champion sponsor DaVita, the initiative is enrolling 150 healthcare sites across 15 U.S. regions to participate in learning and sharing best practices for interdisciplinary care of CKM syndrome, expected to impact the care of more than a quarter-million patients.
