To rebalance the oral microbiome and cure chronic halitosis, researchers at the University of Washington are embarking on a first-of-its-kind experiment. These clinical trials transplant bacteria and other minuscule critters from healthy donors into patients with halitosis. If successful, the healthy microbiota will crowd out the bad and patients’ bad breath will improve.
To rebalance the oral microbiome and cure chronic bad breath, researchers at the University of Washington are embarking on a first-of-its-kind experiment. Credit: iStock
The human mouth is full of wonders. It’s home to hundreds of species of bacteria, fungi, viruses and protozoa, which work in delicate harmony to maintain our oral health. Sometimes, though, this complex system — known as the oral microbiome — can fall out of balance. Anaerobic bacteria build up on the tongue and in the little pockets between our teeth and gums. There, they break down organic matter and spew out a foul odor. This, the current theory goes, is what causes many chronic cases of bad breath, or halitosis.
To rebalance the oral microbiome and cure chronic halitosis, researchers at the University of Washington are embarking on a first-of-its-kind experiment. These clinical trials transplant bacteria and other minuscule critters from healthy donors into patients with halitosis. If successful, the healthy microbiota will crowd out the bad and patients’ bad breath will improve.
Researchers believe an imbalance in the oral microbiome may be a cause of bad breath. Here, a person blows into a halimeter, which measures the presence of foul-smelling compounds in a person’s breath. Credit: Jordon McAdams, University of Washington
“We know the oral microbiome can get out of whack. The question is, can you rebalance it? That is the hypothesis we’re proposing,” said Alvin Wee, a UW professor of restorative dentistry and co-lead of the project.
The experimental procedures build off recent breakthroughs in fecal microbiota transplants, commonly known as stool transplants, which have become a go-to treatment for gastrointestinal infections and bacterial imbalances.
The research team has so far completed four transplants, with preliminary evaluations underway. They’re seeking pairs of participants — a patient with chronic halitosis and a donor, ideally an intimate partner, family member or trusted friend — to undergo these relatively simple procedures.
To start, researchers complete a full periodontal exam of the donor to ensure their microbiome is healthy. Then they collect bacteria from the donor and suspend it in a small volume of saline. At the same time, recipients undergo a deep cleaning to remove the harmful bacteria and disrupt the biofilm — the thin, sticky layer of microorganisms that lines surfaces in the mouth. Recipients rinse with the donor solution, and researchers inject a concentrated version into the gumline. Ninety days after the transplant, participants self-report whether their breath has improved.
“What we’re trying to do is severely disrupt the original bacteria, and then we bring in the new guys to take hold and establish a new biofilm,” said co-lead Alex Pozhitkov, a research scientist and affiliate faculty member in the UW School of Dentistry. “If we bring enough of the new bacteria and they outcompete the ones that we disrupted, the healthy ones will take over. It’s a numbers game.”
This research was funded by the Dean and Margaret Spencer Clinical Research Fund. Co-investigators include professor of clinical practice Diane Daubert and professor Daniel Chan, both of the UW School of Dentistry. For more information, to reach the researchers or to inquire about participating, contact Pozhitkov at pozhit@uw.edu or Wee at awe@uw.edu.
University of Washington researchers launched a pilot app that maps ‘little free pantries’ throughout the Seattle area and gives pantry users and donors new tools to communicate with and help one another.
A micropantry in Seattle’s Beacon Hill neighborhood is stocked with nonperishable food for neighbors in need. In a new study, UW researchers launched an experimental mapping app designed to help users find nearby pantries and communicate with one another about sharing food. The team also outfitted several pantries with sensors that anonymously track usage and stock levels. Photo: Giacomo Dalla Chiara
Micropantries — commonly called “little free pantries” — and community fridges are a frequent sight throughout Seattle and the greater Puget Sound region. One estimate suggests that they supply around 4 million pounds of food per year to neighbors in need in the Seattle area, more than the state’s largest food bank. The curbside cupboards are a decentralized, community-driven effort to fight food insecurity and reduce food waste at the neighborhood level, but their ad hoc nature limits their dependability — users don’t know when food is available without repeatedly checking, and donors don’t know what foods are needed most.
Now, anyone who interacts with micropantries or community fridges in the Seattle area can try out an experimental app, made by University of Washington researchers, that brings a suite of new features to the micropantry network. The app, called PantryMap.org, maps many local pantries across the region. The app also gives each pantry an activity feed where users can share food they’ve donated, report on stock levels, add requests to a wish list, post photos and leave other notes. The research team also retrofitted some pantries with sensors that anonymously auto-report their usage and stock levels to the app in real time.
“This is an effort to document and quantify the phenomenon of micropantries,” said Giacomo Dalla Chiara, a senior research scientist at the UW Urban Freight Lab. “Lots of micropantries and community fridges popped up around the time of the COVID-19 pandemic, and I was curious about who uses them and how they are used.”
The team was cognizant of privacy concerns and designed the smart pantry tech accordingly.
“Putting cameras in the pantries could give us a lot of information about what specific foods are moving through the system, but that may also deter users who are concerned about privacy,” said Vicente Arroyos, a UW doctoral student in the Paul G. Allen School of Computer Science & Engineering who designed and built the sensor suite. “Instead, we settled on simpler sensors that measure weight and interactions like opening the door to measure stock levels while preserving everyone’s anonymity.”
The researchers hope that neighbors will find new ways to connect and help one another through these tools. A user might see that stock levels are low in a nearby pantry, for example, and decide to add some food. Another user might request certain foods to accommodate their dietary restrictions.
The sensor-equipped pantries are a small subset of the dozens of pantries throughout Seattle, but in addition to providing some neighborhoods with enhanced food tracking, they will generate aggregate data that will help Dalla Chiara’s team study donor and usage behavior. Dalla Chiara also plans to survey donors to learn more about what motivates people to provide food to pantries.
“We know that there is a lot of food insecurity in Seattle and in the United States in general,” Dalla Chiara said. “But we know that there is also a lot of food waste — lots of people have a surplus of food. And we want to see how grassroots efforts like micropantries can address both food insecurity and waste at the same time.”
Dalla Chiara and his team recently completed a refit on a cold, sleetingMarchday at a pantry owned by Saint Paul’s Episcopal Church near Seattle Center. The church keeps the pantry regularly stocked, and rector Stephen Crippen is curious about the data the new system will produce.
“It puts numbers on what we’re actually accomplishing,” Crippen said. “It helps us get in touch with what’s going on on this street.”
The research team is also working with local businesses and nonprofits to encourage and track food distribution throughout the pantry network. In April, Seattle-based recycling startup Ridwell ran a nonperishable food drive across Seattle and delivered 25,000 pounds of food to the University District Food Bank; from there, volunteers from the Cascade Bicycle Club’s Pedaling Relief Project distributed the food to micropantries around the city by bike, giving the network an infusion of both food and usage data. The Washington State Department of Health and the nonprofit Sustainable Connections helped support the project’s community fridges effort.
Dalla Chiara recognizes that there are other grassroots micropantry mapping efforts online, and he doesn’t want his app to replace those services. Nor does he expect the smart pantry network to remain in service indefinitely — it costs about $150 to retrofit each pantry with sensors, and all that tech will be difficult to maintain after the study concludes in October of this year. At its core, the project is an effort to learn about micropantry usage and explore how technology might encourage sharing of resources and mutual aid systems.
“We’re trying to measure and quantify goodwill,” Dalla Chiara said. “Behind each little free pantry there is a whole system of behaviors — people trying to help one another. If we can understand that system better, we can support it better.”
Other UW collaborators include Anne Goodchild, professor of civil and environmental engineering and director of the Urban Freight Lab; Emily Hovis, assistant teaching professor of environmental and occupational health sciences; Marie Spiker, assistant professor of food systems, nutrition and health; and Vikram Iyer, assistant professor in the Allen School.
For more information, contact Dalla Chiara at giacomod@uw.edu.
New research led in part by the University of Washington found that state-level abortion restrictions enacted after the Dobbs ruling are not only affecting the current medical workforce — they may be shaping the next generation of physicians.
By October 2022 — four months after the Dobbs ruling — more than a dozen states had tightened abortion restrictions. Those states are shown here in blue.
In the three-and-a-half years since the U.S. Supreme Court overturned the constitutional right to an abortion in Dobbs v. Jackson Women’s Health Organization, the fragmented state of abortion access has put medical professionals in a precarious position. Many states have tightened abortion restrictions, with some enacting criminal penalties up to life in prison for physicians who perform abortions. Medical schools have curtailed abortion-related curricula.
New research led in part by the University of Washington found that the new restrictions are not only affecting the current medical workforce — they may be shaping the next generation of physicians. The study, published March 2 in JAMA Network Open, found that applications to medical residency programs in states that enacted new abortion restrictions dropped sharply following the Dobbs ruling.
Anirban Basu, UW professor of health economics and director of the Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute
The decrease occurred among both male and female applicants. Applications to specialties related to reproductive health — obstetrics and gynecology, family medicine, internal medicine and emergency medicine — saw the largest decreases.
The new study builds on previous research that had shown decreased application rates to residency programs in states with abortion restrictions by applying causal methodologies to understand the impact of the Supreme Court decision and isolating results from male and female applicants.
“This research provides important empirical evidence about how state-level policy changes following Dobbs may influence decisions made by medical trainees about where to pursue their graduate medical education,” said co-author Anirban Basu, a UW professor of health economics and director of the Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute.
To learn more about the research, UW News sat down the paper’s three authors: Basu; lead author Dr. Anisha Ganguly, assistant professor of medicine at the University of North Carolina at Chapel Hill; and co-author Dr. Anna Morenz, assistant clinical professor of internal medicine at the University of Arizona. Both Ganguly and Morenz completed their internal medicine residencies at the UW School of Medicine.
The medical residency match process is quite different from traditional higher-ed applications. Can you explain how that works, and how it relates to your study’s findings?
Dr. Anna Morenz: Applicants may apply to as many programs as they want, with some applying to dozens of programs. At the end of interviews, they’ll rank those programs based on their preferred landing spots. The programs, in turn, will rank all the applicants that they received. A computer algorithm then matches everyone with the goal of filling all the residency slots, and it’s very good at that. We know that almost all open residency slots in the U.S. are filled. So programs are still filling their residency slots even in states with restrictions.
What concerns us about these findings is that there’s an early signal of people avoiding applications to these states. That has potential implications for the quality of the applicants to restricted states, which could not be assessed in our data. There’s typically a high likelihood that people stay where they train for their residency, but if you landed in a restricted state that was low on your rank list, you may be more likely to complete your training and then leave to a non-restricted state. We aim to look at this very important question in projects to come.
Anna Morenz, assistant clinical professor of general internal medicine at the University of Arizona.
Anisha and Anna, you’re both practicing primary care physicians. How big a part of a physician’s training is abortion and other pregnancy-related care?
Dr. Anisha Ganguly: It’s not a big part of our training traditionally, though there has been a movement to integrate more abortion care into primary care residencies. That’s more the case in family medicine rather than internal medicine, because medication abortion has now become the most common means for abortion care. As internists, we commonly diagnose pregnancies and care for women with medical conditions as they consider family planning.
AM: I do think it’s important to note that a huge percentage of primary care physicians are trained in family medicine. And family medicine physicians are trained in delivery of babies, management of prenatal care, miscarriage management, contraception and abortion. Anisha and I trained in internal medicine, and there is increasing interest to include medication abortion training in internal medicine, as it is fully within our scope of practice.
The effects of the Dobbs decision have been well-documented, and previous work on this topic highlighted changes in OB/GYN residency applications. What’s new in your study specifically?
Anirban Basu: We had a much longer pre-period than previous studies. We looked back to 2019 to see what had been happening to application rates in these two kinds of states — those that eventually restricted abortion access and those that didn’t — and we showed that these rates had been moving similarly until the ruling. That gives a little more weight to the evidence to say the change is due to the ruling.
The second big thing is that previous studies did not distinguish whether men and women were changing their behavior similarly. I think that’s a very important finding in our study, that male applicants are changing their behavior at an even higher rate.
AG: I agree that the gender stratification was an important contribution. The other stratified analysis that we explored was about how specialty type may be driving some of the effects that we saw. A lot of people can reason that OB/GYN applicants would be affected by this directly, and there’s a lot of literature to support that. But what we’re showing is that it’s not just the OB/GYN workforce that’s going to be impacted. It’s the primary care workforce and the emergency medicine workforce.
We’re hoping that message spreads a little more broadly. This is not just about women’s health. It’s about the future of primary care and the person who’s going to save you from your heart attack in the future.
Let’s talk a little more about that gender stratification. You found that male applicants changed their application preferences at a greater rate than female applicants, which looks like a surprising result. What’s going on there?
AG: When we generated our original hypotheses, we thought we were going to see increased effects among women applying to residency, but we actually ended up seeing that there were long-term disparities that existed pre-Dobbs between restricted and non-restricted states. This was likely because of the laws targeting abortion providers and other state-level laws that were affecting women’s behavior. What we’re seeing is that women had been reading the tea leaves about access to reproductive health care prior to the Dobbs decision, but the decision did unmask a wider problem that drove a lot of new behavior among men.
Dr. Anisha Ganguly, assistant professor of medicine at the University of North Carolina at Chapel Hill
One of the messages that we are getting from this paper is this is an “all of us” problem. It’s not just about women physicians. It’s about men who are also making choices about their professional autonomy and also about access to reproductive health care for their families. Women have been and will be considering their personal access to care and autonomy before this decision, but perhaps these state restrictions after Dobbs may have newly increased awareness among men.
Among all these shifts, you found one group whose application rates didn’t change significantly: people applying to highly competitive medical specialities. What do you think explains that stickiness?
AG: Anna and I had brainstormed about this being a potential effect modifier, because people who are applying in highly competitive specialties like orthopedic surgery or dermatology apply very broadly and don’t get to exercise a lot of choice about where to go. Whereas for large specialities like internal medicine, family medicine or pediatrics, there are a lot of programs in a lot of places, so applicants have more options. In those cases, state-level policies like abortion restrictions can factor more into people’s decision-making.
At an institutional level, what changes could be made to address these trends?
AG: Institutions can make choices to mitigate some of these effects by supporting candidates with access to reproductive care within the scope of the restrictions that exist. Other industries are building in travel benefits for women who may need to travel to access these services.
It’s not this aspect of a decision alone that shapes a residency applicant’s choice to go to a specific place or program. But there are other things that institutions can do to make trainees, particularly women, feel supported and valued. If you’re existing in an environment where state policies make women feel a lack of autonomy, then there are workforce policies that can be in place to bolster that sense of autonomy. That could take the shape of parental leave policies, lactation policies, other things that institutions can do to make women feel like, even if this part of your voice has been taken away, we’ll help you with the rest.
AB: One policy that has a long history of literature supporting it is financial incentives. Physicians do respond to financial incentives, but in many cases those incentives need to be quite steep to get people to change their decisions.
AM: The other option is training opportunities. A lot of programs in states that had laws or restrictions that preceded the Dobbs decision would set up partnerships with organizations in another state where they could send their trainees to learn about pregnancy termination and miscarriage management. That’s a burden on residency programs and residents both. You have to set up housing and travel agreements. But that’s another key thing that programs need to keep in mind in order to recruit applicants.
For more information or to contact the researchers, contact Alden Woods at acwoods@uw.edu.
The WIC program provides families food in specific categories. New research finds that households who redeem more of their benefits in the most popular food categories are more likely to remain in the program long-term.
WIC participants who redeem more of their benefits in the most popular food categories, such as fruits and vegetables and eggs, are more likely to stay in the program, according to new research. Credit: Alexas_Fotos via Pixabay.
But many families who are income eligible to participate in WIC aren’t receiving those benefits. Research has found that households who don’t use the full amount of their nutrition benefits are more likely to drop from the program.
New research by the University of Washington has found that households who redeem more of their benefits in the most popular food categories are more likely to remain in the program long-term. Better understanding these patterns could help WIC agencies identify families who might need a little extra encouragement to stay enrolled.
“Finding ways to identify kids and families that are at risk of dropping out of the program is of high importance,” said Pia Chaparro, a UW assistant professor of health systems and population health and first author of the study. “That’s basically what we’ve identified — a way to flag families who may be at risk of dropping off.”
WIC provides families with food benefits in specific categories, with fruits and vegetables and eggs as the most popular. In partnership with Public Health Foundation Enterprises WIC (PHFE WIC), a Southern California WIC agency with a large research and evaluation division, researchers analyzed redemption data from 188,000 participating infants and children 0-3 years old, between the years 2019 and 2023.
Among those children, higher redemption of fruits and vegetables, eggs, whole milk and infant formula was associated with lower risk of their household discontinuing WIC participation.
The risk of discontinuation decreased in a somewhat linear fashion as redemption rates increased.
Chaparro hopes that local WIC agencies will build on these findings and seek new ways to engage families at risk of dropping off. All WIC providers must offer nutrition education, which could be an opportunity to target households with lower redemption rates in popular categories.
The findings come just over a year after the U.S. Department of Agriculture, which oversees WIC, implemented significant updates to the program’s food package. Among other changes, the 2024 rule significantly increased benefits for fresh fruits and vegetables, which has proven popular.
“The expansion of fruit and vegetable benefits for WIC families has been among the most important policy changes of the last decade,” said Shannon Whaley, director of research and evaluation at PHFE WIC and co-author of the study. “Families want more fruits and vegetables, and this research demonstrates that their inclusion in the WIC food package is essential for longer-term engagement in the program.”
Research led by the University of Washington and Kaiser Permanente Southern California sheds new light on how the 2025 Los Angeles fires affected people’s health, and how people navigated the health care system during an emergency.
Smoke rises above the Los Angeles skyline during the January 2025 wildfires. In the week after the fires ignited, members of Kaiser Permanente Southern California made 42% more virtual health care visits for respiratory symptoms, according to new research led by Kaiser Permanente and the UW. Credit: Erick Ley, iStock
When uncontrolled wildfires moved from the foothills above Los Angeles into the densely populated urban areas below in January 2025, evacuation ensued and a thick layer of toxic smoke spread across the region. Air quality plummeted. Local hospitals braced for a surge,but it never came.
Research led by the University of Washington and Kaiser Permanente Southern California sheds new light on how the Los Angeles fires affected people’s health, and how people navigated the health care system during an emergency. In the rapid study, published Nov. 26 in JAMA Health Forum, researchers analyzed the health records of 3.7 million Kaiser Permanente members of all ages living in the region. They found that health care visits did rise above normal levels, especially virtual services.
Related: The UW RAPID Facility created a dataset of aerial imagery and 3D models from the 2025 Los Angeles wildfires. Learn more here.
In the week after the fires ignited, Kaiser Permanente members made 42% more virtual visits for respiratory symptoms than expected. Those living near a burn zone or within Los Angeles County also made 44% and 40% more virtual cardiovascular visits, respectively, than expected.
In-person outpatient visits for respiratory symptoms also increased substantially. Members who lived near a burn zone or within Los Angeles County made 27% and 31% more virtual cardiovascular visits, respectively, than expected.
Extrapolating to all insured residents of the county, the researchers estimated an excess of 15,792 cardiovascular virtual visits, 18,489 respiratory virtual visits and 27,903 respiratory outpatient visits in the first week of the fires.
The results suggest that people may rely more heavily on virtual health care during climate-related emergencies, and that providers should better prioritize virtual and telehealth services as they prepare for future crises.
“We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care,” saidJoan Casey, a UW associate professor of environmental and occupational health sciences and of epidemiology who led the research. “While the fires clearly impacted health, virtual care likely enhanced the ability of providers to meet the health care needs of people experiencing an ongoing climate disaster.”
In collaboration with Kaiser Permanente Southern California, an integrated health care system with millions of members across the region, researchers analyzed health records of people who were highly or moderately exposed to wildfires. They defined high exposure as living within about 12 miles (20 kilometers) of a burn zone, and moderate exposure as living within Los Angeles County but farther than 12 miles during the time of the fires.
Researchers looked back three years to estimate how many health care visits to expect in the weeks following Jan. 7 — the first day of the fires — under typical conditions. They then estimated how many people sought care in the first week of the fires, when smoke levels were highest, evacuations took place, and Los Angeles County public schools were closed.
In addition to the spike in cardiovascular and respiratory visits, researchers found a sharp increase in the number of visits for injuries and neuropsychiatric symptoms. On Jan. 7, outpatient injury visits were 18% higher than expected among highly exposed members, and virtual injury visits were 26% and 18% higher than expected among highly and moderately exposed groups, respectively. Among those same groups, outpatient neuropsychiatric visits rose 31% and 28% above expectations, respectively.
While both groups made significantly more visits than expected, proximity to the fires mattered. When researchers zoomed in on respiratory-related virtual visits, they found that minimally exposed members made 31% more visits, moderately exposed members made 36% more, and those living in highly exposed areas made 42% more.
“While healthcare systems often plan to increase the number of hospital beds available or clinic staffing during an emergency, this work highlights the importance of considering virtual care capacity,” saidLauren Wilner, a UW doctoral student of epidemiology and co-author on the study. “This may be particularly true for climate disasters like wildfires, during which people are advised to stay indoors or when people must evacuate — motivating them to seek care online if at all possible. As climate disasters increase in frequency and intensity, it is essential that health care systems know how to prepare for a sudden and dramatic surge in health care utilization.”
Funding designed to improve access to oral healthcare services for low income people with HIV, and to train dental students, dental hygiene students, and dental residents to deliver dental care to people with HIV. HRSA has a focus on those who are medically vulnerable or live in areas with limited access to care. Geographic coverage: Nationwide -- Health Resources and Services Administration, HRSA HIV/AIDS Bureau, U.S. Department of Health and Human Services
Scholarships for Doctor of Pharmacy degree students who are enrolled in a U.S. college or school of pharmacy. Awardees must demonstrate leadership, academic success, and a commitment to serving rural, Medically Underserved Areas, and/or Medically Underserved Populations. Geographic coverage: Nationwide -- American Association of Colleges of Pharmacy, Walmart
Reimbursement funding to Tribal governments exercising Special Tribal Criminal Jurisdiction (STCJ) for covered crimes, which are assault of Tribal justice personnel; child violence; dating violence; domestic violence; obstruction of justice; sexual violence; sex trafficking; stalking; and violation of a protection order. Geographic coverage: Nationwide -- Office on Violence Against Women, U.S. Department of Justice
Funding to increase the number of dental and dental hygiene faculty in the workforce by assisting training programs to attract and retain full-time faculty through loan repayment programs, including those that provide care to and meet the oral health needs of rural and medically vulnerable population. Geographic coverage: Nationwide -- Bureau of Health Workforce, Health Resources and Services Administration, U.S. Department of Health and Human Services
Honorary awards to recognize individuals, organizations, and programs whose leadership and work has affected change or impacted healthcare for American Indian/Native American populations at the local, tribal, regional, and/or national level. Geographic coverage: Nationwide -- National Indian Health Board
La clasificación clínica del síndrome cardiovascular-renal-metabólico (cardiovascular-kidney-metabolic, CKM), la detección de factores de riesgo y las estrategias de prevención y tratamiento se detallan en una nueva guía conjunta de la American Heart Association y el American College of Cardiology
Aspectos destacados de la guía:
En la primera guía de práctica clínica sobre el síndrome cardiovascular-renal-metabólico (CKM) de la American Heart Association y el American College of Cardiology se detalla la estadificación para evaluar cómo funcionan los riñones, el metabolismo y el corazón de una persona. Los estadios más avanzados del síndrome CKM se asocian con una mayor carga de afecciones de salud graves, como la diabetes tipo 2, la enfermedad renal crónica y un mayor riesgo de enfermedades cardiovasculares y mortalidad.
En la guía se revisan los factores de riesgo del síndrome CKM, incluido el sobrepeso/la obesidad, la prediabetes/diabetes tipo 2, la presión arterial alta y los lípidos anormales, así como la enfermedad renal crónica.
Las recomendaciones integrales incluyen la detección, la prevención y el tratamiento para las personas con síndrome CKM o en riesgo de desarrollarlo. Se recomiendan hábitos de vida saludables; medicamentos, incluidas las terapias basadas en GLP-1 y los inhibidores de SGLT2; y/o cirugía metabólica y bariátrica, cuando sea apropiado, con el objetivo de prevenir, controlar y, potencialmente, revertir la evolución del síndrome CKM.
Prohibida su divulgación hasta la 1:00 p. m., CT/2:00 p. m., ET del martes 9 de junio del 2026
DALLAS y WASHINGTON, 9 de junio del 2026 — La American Heart Association (Asociación Americana del Corazón) y el American College of Cardiology, junto con otras dos organizaciones médicas líderes, desarrollaron la primera guía de su tipo destinada a prevenir y controlar el síndrome cardiovascular-renal-metabólico (CKM) (sitio web en inglés), un conjunto interconectado de afecciones de salud que aumentan significativamente el riesgo de complicaciones multiorgánicas y resultados cardiovasculares negativos. Casi el 90% de los adultos estadounidenses tiene al menos un factor de riesgo del síndrome CKM, entre ellos sobrepeso, presión arterial alta, lípidos anormales, hiperglucemia (nivel alto de azúcar en sangre) o la función renal reducida.
En esta nueva guía de práctica clínica, publicada hoy en Circulation, la revista médica insignia revisada por pares de la American Heart Association, y en JACC, la revista médica insignia del American College of Cardiology, se detallan recomendaciones para ayudar a los profesionales de la salud y a las personas a identificar antes el riesgo de síndrome CKM y a tomar medidas para proteger la salud cardíaca, metabólica y renal a largo plazo.
Según estadísticas recientes tanto de la American Heart Association (sitio web en inglés) como del American College of Cardiology (sitio web en inglés), el 40% de los adultos y el 21% de los niños y adolescentes en los Estados Unidos tienen obesidad, definida como un exceso de grasa corporal que representa un riesgo para la salud. La obesidad es un factor de riesgo de presión arterial alta, diabetes tipo 2, disfunción metabólica, enfermedades cardiovasculares y enfermedades renales (sitio web en inglés).
"Las enfermedades cardíacas, renales y metabólicas no se presentan de forma aislada, sino que están profundamente relacionadas", afirmó el Dr. Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA, presidente del comité de redacción de las guías y director de investigación sobre obesidad y enfermedades cardiometabólicas en la Facultad de Medicina de la Universidad Johns Hopkins en Baltimore. "Esta guía aboga por una detección y atención más tempranas, centrándose en la prevención y en la acción coordinada para reducir el riesgo de enfermedad cardiovascular antes de que se desarrollen complicaciones graves o se produzca un evento cardíaco importante".
¿Cuáles son las etapas del síndrome cardiovascular-renal-metabólico (CKM)?
Hay cuatro etapas del síndrome CKM. Estas etapas identifican el riesgo y adaptan las estrategias de prevención para ralentizar, o incluso revertir, la evolución del síndrome CKM:
Etapa 1: personas con sobrepeso/obesidad o prediabetes, pero sin otros factores de riesgo metabólico, enfermedad renal o enfermedad cardiovascular.
Etapa 2: incluye a personas con uno o más factores de riesgo metabólico (como presión arterial alta, niveles anormales de lípidos, diabetes tipo 2 o síndrome metabólico) y/o enfermedad renal, pero sin enfermedad cardiovascular.
Etapa 3: personas con enfermedad cardiovascular subclínica (asintomática) y factores de riesgo de CKM; o aquellas con equivalentes de riesgo de enfermedad renal crónica de muy alto riesgo o alto riesgo previsto de enfermedad cardiovascular a 10 años (basado en las ecuaciones PREVENT-CVD).
Entre los aspectos más destacados de la guía se incluyen:
Una mejor evaluación del riesgo mediante el uso de las ecuaciones PREVENT(Predicting Risk of Cardiovascular Disease EVENTs) para estimar el riesgo de enfermedad cardiovascular a 10 y 30 años, lo que puede ayudar a orientar los planes de tratamiento y de estilo de vida personalizados. PREVENT incluye factores relacionados con la salud renal y metabólica en las ecuaciones, lo que permite una estimación del riesgo más completa y precisa en comparación con herramientas anteriores.
También se recomienda la detección de factores socialesque afectan la salud, como la inseguridad alimentaria, la inestabilidad de la vivienda y las dificultades económicas, para identificar a las personas con mayor riesgo de desarrollar el síndrome CKM.
Se hace hincapié en la atención interdisciplinaria coordinada y en los hábitos de vida saludables, incluidos la atención a la actividad física, la nutrición, el peso, la presión arterial, el azúcar en sangre y el colesterol, para prevenir y controlar el síndrome CKM.
Junto con el control del estilo de vida, las opciones de tratamiento adicionales para el síndrome CKM incluyen medicamentos y terapias quirúrgicas, como medicamentos para controlar la presión arterial, el colesterol, el azúcar en sangre y el peso, a fin de proteger el corazón y los riñones. Por primera vez, se recomiendan terapias basadas en GLP-1 para personas seleccionadas con obesidad y/o diabetes tipo 2, y otros factores de riesgo de enfermedad cardiovascular, para reducir el riesgo de eventos cardíacos. La cirugía metabólica y bariátrica también puede utilizarse para tratar el síndrome CKM.
¿Qué deben hacer las personas para prevenir el síndrome CKM?
En la guía se destaca que cambiar el estilo de vida puede marcar una diferencia significativa en la salud general. Tomar medidas a tiempo puede ayudar a prevenir un ataque cardíaco, insuficiencia cardíaca, ataque cerebral o insuficiencia renal. Se recomienda a las personas que sigan los Life’s Essential 8 de la American Heart Association, medidas recomendadas para mejorar y mantener la salud cardiovascular.
"Life’s Essential 8 se centra en la actividad física regular, una alimentación saludable para el corazón, el mantenimiento de un peso saludable, el control de la presión arterial, el azúcar en sangre y el colesterol, así como en evitar el consumo de tabaco y dormir lo suficiente con un sueño de calidad. Todas estas son herramientas poderosas para mejorar la salud cardiovascular, renal y metabólica", afirmó la Dra. Fátima Rodríguez, M.P.H., FAHA, FACC, vicepresidenta del comité de redacción y profesora asociada de medicina cardiovascular en Stanford Medicine, en Stanford, California. "Estas medidas reducen el riesgo de enfermedad cardíaca y también favorecen la salud renal y metabólica durante toda la vida".
La guía, dirigida por el Comité Conjunto de Guías de Práctica Clínica de la American Heart Association y el American College of Cardiology, se desarrolló en colaboración con la Asociación Americana de Diabetes, la Asociación de Obesidad de la Asociación Americana de Diabetes y la Sociedad Americana de Nefrología, y cuenta con su respaldo. En el manuscrito se indican los miembros del comité de redacción de la guía y las declaraciones de los autores.
La Asociación recibe más de un 85% de sus ingresos de fuentes que no son empresas. Estas fuentes incluyen contribuciones de personas particulares, fundaciones y patrimonios, así como ganancias por inversiones e ingresos por la venta de nuestros materiales informativos. Las empresas (incluidas las farmacéuticas, los fabricantes de dispositivos y otras compañías) también realizan donaciones a la Asociación. La Asociación tiene políticas estrictas para evitar que las donaciones influyan en el contenido científico y en las posturas de sus políticas. La información financiera general está disponible aquí (sitio web en inglés).
Recursos adicionales:
El material multimedia disponible se encuentra en la columna derecha del enlace del comunicado, e incluye fragmentos de entrevistas en video con Fátima Rodriguez, M.D., M.P.H., FAHA, FACC; y Claudia Mercado, sobreviviente de un ataque cardíaco. Desplácese por las miniaturas para ver el tema y la opción de descarga de cada clip.
Declaración científica de la American Heart Association y el American College of Cardiology: Uso de la relación riesgo-beneficio para orientar la toma de decisiones sobre los tratamientos de CKM en la prevención primaria de las enfermedades cardiovasculares, publicada en Circulation (sitio web en inglés) y en JACC (sitio web en inglés) (prohibida su divulgación hasta las 2 p. m. ET, del 9 de junio del 2026
Información de CardioSmart.org del American College of Cardiology sobre la conexión entre el corazón y los riñones (sitio web en inglés) (prohibida su divulgación hasta las 2 p. m. ET, del 9 de junio del 2026
Siga las noticias de la American Heart Association/American Stroke Association en X en @HeartNews
Siga las noticias de Circulation, la revista insignia de la American Heart Association, en @CircAHA.
Siga las noticias de JACC, la revista médica insignia del ACC, @JACCJournals
###
Acerca de la American Heart Association
La American Heart Association es una fuerza incansable que trabaja por un mundo con vidas más largas y saludables. La organización ha sido una fuente líder de información sobre salud durante más de cien años y su objetivo es garantizar la equidad en la salud en todas las comunidades. Con el apoyo de más de 35 millones de voluntarios en todo el mundo, financiamos investigaciones vanguardistas, defendemos la salud pública y proporcionamos recursos fundamentales para salvar y mejorar vidas afectadas por enfermedades cardiovasculares y ataques o derrames cerebrales. Trabajamos incansablemente para hacer avanzar la salud y transformar vidas cada día mediante el impulso de avances y la implementación de soluciones comprobadas en las áreas de ciencia, políticas y cuidados. Comuníquese con nosotros en heart.org, Facebook o X, o llame al 1-800-AHA-USA1.
Acerca del American College of Cardiology
El American College of Cardiology (ACC) es el líder mundial en la transformación de la atención cardiovascular y la mejora de la salud cardíaca para todos. Como fuente destacada de formación médica profesional para todo el equipo de atención cardiovascular desde 1949, el ACC acredita a profesionales cardiovasculares en más de 140 países que cumplen con estrictos requisitos y lidera la elaboración de políticas, estándares y directrices sanitarias. A través de su serie reconocida mundialmente de revistas médicas JACC, los registros del National Cardiovascular Data Registry (NCDR, Registro Nacional de Datos Cardiovasculares), los servicios de acreditación del ACC, la red global de secciones de miembros, los recursos para pacientes de CardioSmart y mucho más, el Colegio se compromete a garantizar un mundo donde la ciencia, el conocimiento y la innovación optimicen la atención y los resultados para los pacientes. Obtenga más información en www.ACC.org (sitio web en inglés) o siga a @ACCinTouch.
Para consultas de los medios de comunicación: 214-706-1173
Los profesionales de cuidados de salud y las personas en general tratan estas afecciones de manera individual, pero están muy conectadas. Por primera vez, una directriz clínica aborda la conexión
Aspectos destacados de la historia
La primera directriz para el síndrome cardiovascular-renal-metabólico (síndrome CKM), publicada hoy por la American Heart Association (Asociación Americana del Corazón) y el American College of Cardiology, identifica la obesidad como un factor metabólico clave en el desarrollo y la progresión del síndrome.
La directriz insta conversaciones anticipadas y enfocadas en la prevención acerca del peso y la salud metabólica.
La directriz indica que usar orientadores o coordinadores de atención mejora el cuidado al permitir coordinar la atención entre el paciente, el médico de atención primaria y el especialista.
Prohibida su divulgación hasta las 1 p. m. CT/2 p. m. ET del martes, 9 de junio del 2026
DALLAS, 9 de junio del 2026 — La primera directriz clínica para el síndrome cardiovascular-renal-metabólico (sitio web en inglés), o síndrome CKM, identifica el exceso de peso, sobre todo en el abdomen, como un factor clave para el síndrome. La directriz tiene como objetivo concienciar más a las personas sobre el modo en que se interconectan la enfermedad cardíaca, la enfermedad renal y las condiciones metabólicas (incluidas la diabetes y la obesidad).
A medida que las tasas de obesidad siguen aumentando (sitio web en inglés), la directriz destaca mantener un peso saludable y convocar a profesionales del cuidado de la salud para que coordinen con sus pacientes conversaciones centradas en la prevención sobre cómo el control del peso ahora puede prevenir futuros problemas de salud.
“En cuanto a la salud CKM, el peso no es solo un número en una balanza; hay personas con el mismo peso corporal que pueden tener perfiles de salud muy diferentes”, afirma Chiadi E. Ndumele, M.D., Ph.D., voluntario de la American Heart Association y jefe del comité de redacción de la nueva directriz, publicada conjuntamente por la American Heart Association y el American College of Cardiology. “En cambio, lo más importante es cómo el tejido graso afecta su salud metabólica. Eso incluye la forma en que el cuerpo controla los niveles de azúcar en sangre y cómo se usa y almacena la grasa”.
La directriz para el síndrome CKM reemplaza la directriz del 2013 para el control del sobrepeso y la obesidad publicada por la Heart Association y otras sociedades.
El síndrome CKM fue definido por primera vez (sitio web en inglés) por la American Heart Association en el 2023.
“El síndrome CKM es una amenaza para la salud pública real y creciente”, afirma Ndumele, director de investigación cardiometabólica de la obesidad en la Johns Hopkins University en Baltimore.
Destaca que, si bien muchas personas pueden saber que padecen enfermedades cardíacas, enfermedades renales o diabetes, posiblemente no sepan qué tan estrecha es la conexión que existe entre esas afecciones. Padecer una de ellas aumenta el riesgo de padecer otras, un desafío común del síndrome CKM. Tener obesidad también aumenta ese riesgo.
“El desafío es cómo conectar las recomendaciones de los diferentes médicos que pueden especializarse en solo una de esas afecciones”, comentó. “Por eso intentamos ayudar a los médicos de diversas especialidades para que se expresen en un idioma en común y estén en sintonía, sobre todo en lo que respecta al control del peso y a sus consecuencias clínicas”.
“Mantener un peso saludable (sitio web en inglés) siempre se consideró esencial para la salud del corazón (sitio web en inglés) y para prevenir otras enfermedades crónicas. Sin embargo, los médicos no siempre sacan el tema del peso a menos que un paciente lo plantee y, por lo general, el enfoque está en la apariencia y no en la salud”, afirma Ambar Kulshreshtha, M.D., Ph.D., miembro voluntario del Consejo de Calidad de la Atención e Investigación de Resultados de la Heart Association y médico de atención primaria que también ayudó a redactar la nueva directriz.
La nueva directriz brinda a los profesionales del cuidado de la salud un motivo para discutir sobre el peso, no como una cuestión estética, afirma, sino como un factor de riesgo que puede derivar en daños orgánicos.
“Estamos afirmando que la prevención es tan importante como el tratamiento, si es que no es más importante”, mencionó Kulshreshtha, que es profesor adjunto en el departamento de medicina familiar y preventiva de la Facultad de Medicina de Emory University en Atlanta.
En términos médicos, el problema del sobrepeso o la obesidad radica en la acumulación de tejido graso en el abdomen, el cual se adhiere a los órganos del abdomen. Esa grasa puede causar inflamación (sitio web en inglés), que deriva en resistencia a la insulina y ocasiona problemas en la forma en que los vasos sanguíneos se dilatan y contraen.
A medida que persisten estos problemas, el síndrome CKM va progresando hasta causar diabetes, enfermedad renal y, con el tiempo, daños orgánicos que pueden incluir insuficiencia renal, insuficiencia cardíaca, enfermedad hepática, ataques cardíacos o derrames cerebrales.
Pero si se detecta de manera temprana, es posible detener e incluso revertir el proceso de la enfermedad en el síndrome CKM.
Cuando Kulshreshtha les explica el síndrome CKM a sus propios pacientes, compara los vasos sanguíneos del cuerpo con las tuberías del hogar. La obesidad causa inflamación, que él compara con el óxido.
“El óxido puede dañar las tuberías, que son como su sistema vascular”, afirma. “Puede dañar la bomba, que sería su corazón. Y puede dañar los filtros, que serían los riñones”.
Ndumele comentó que la directriz ofrece maneras para que los profesionales del cuidado de la salud puedan discutir sobre el peso sin críticas. “Comienza con el interrogante ‘¿Es oportuno ahora que abordemos su peso y su salud, y cómo pueden estar afectándose entre sí?’”
La idea es ponerles fin a los problemas difíciles de tratar antes de que surjan.
“Entre las diversas consecuencias de la obesidad, se incluyen diabetes, enfermedad renal crónica y enfermedad cardiovascular. La directriz brinda a los profesionales del cuidado de la salud enfoques para identificar y manejar estas afecciones”, comentó Ndumele. “Creo que todo médico conoce a algún paciente que sufre estas afecciones. A menudo son pacientes hospitalizados y ambulatorios; nosotros compartimos las frustraciones de los pacientes a la hora de manejar las diversas afecciones e intentar mantener un buen estado de salud”.
El exceso de peso aumenta el riesgo de enfermedades cardíacas y derrames cerebrales en al menos un 21% en los hombres y un 32% en las mujeres, según la American Heart Association. Además, cada incremento de 5 unidades en el índice de masa corporal (BMI) está asociado a un 41% más de riesgo de insuficiencia cardíaca.
Las conversaciones anticipadas y “una variedad de herramientas cada vez mayor”, dice Ndumele, pueden evitarles a las personas alcanzar esas etapas peligrosas e incluso revertir el síndrome CKM en sus formas tempranas.
“La directriz incluye estrategias probadas para respaldar las prácticas de un estilo de vida saludable, como las bases para el manejo del síndrome CKM”, comentó. “También describe el uso de medicamentos cada vez más efectivos que benefician a diversos sistemas corporales. Se incluyen los inhibidores de la SGLT2, terapias basadas en GLP-1 y antagonistas de los receptores de mineralocorticoides no esteroideos. Buscamos que las personas de la comunidad sean más conscientes de que ‘Existe un proceso’ y de que, si se interviene de forma anticipada, ‘Puedo mejorar drásticamente mis resultados a largo plazo’”.
Además de cambiar la forma en que los médicos les hablan a los pacientes sobre el peso, las directrices ofrecen principios generales para mejorar la manera en que los profesionales del cuidado de la salud trabajan en conjunto para abordar la obesidad, la diabetes, la enfermedad renal crónica y la enfermedad cardíaca.
“Nosotros, como médicos de atención primaria o subespecialistas, operamos de manera aislada”, afirma Fatima Rodriguez, M.D., M.P.H., vicejefa del comité de redacción de la directriz y jefa de cardiología preventiva en la Universidad de Stanford. “Pero las personas con síndrome CKM no padecen una afección a la vez, por lo general todo ataca al mismo tiempo”.
Mencionó que al trabajar con otros miembros del equipo de cuidados de salud, es posible tratar a los pacientes de forma integral.
“Las personas agradecen que les vean y traten de manera holística”, comentó. “La idea es que el cuidado del paciente sea un trabajo en equipo, del cual el paciente sea el capitán”.
La directriz detalla los beneficios de usar coordinadores de CKM, u orientadores, a fin de coordinar el cuidado entre los diferentes profesionales del cuidado de la salud y los pacientes, y para garantizar una atención de seguimiento. Como parte de la atención integral, la directriz también enfatiza la identificación de las barreras sociales a la atención médica de calidad y a un estilo de vida saludable, así como el apoyo social cuando resulte necesario.
“Investigaciones demostraron que los equipos interdisciplinarios generan un impacto drástico en cómo se sienten las personas con relación a su atención y qué tan exitoso es el tratamiento”, afirmó Ndumele. “Nuestro objetivo aquí es cambiar algunos de nuestros paradigmas para no esperar a que la enfermedad nos alcance, sino para ayudar a las personas a prevenir muchas enfermedades a largo plazo”.
En el 2024, la American Heart Association presentó la CKM Health Initiative para brindar un camino a seguir en el cual pacientes, comunidades y profesionales de la atención médica puedan mejorar los diagnósticos y el tratamiento del síndrome CKM. Obtenga más información en la página de la iniciativa (sitio web en inglés) en heart.org.
La Asociación recibe más de un 85% de sus ingresos de fuentes que no son empresas. Estas fuentes incluyen contribuciones de personas particulares, fundaciones y patrimonios, así como ganancias por inversiones e ingresos por la venta de nuestros materiales informativos. Las empresas (incluidas las farmacéuticas, los fabricantes de dispositivos y otras compañías) también realizan donaciones a la Asociación. La Asociación tiene políticas estrictas para evitar que las donaciones influyan en el contenido científico y en las posturas de sus políticas. La información financiera general está disponible aquí (sitio web en inglés).
Recursos adicionales:
El material multimedia disponible se encuentra en la columna derecha del enlace del comunicado, e incluye fragmentos de entrevistas en video con Fátima Rodriguez, M.D., M.P.H., FAHA, FACC; y Claudia Mercado, sobreviviente de un ataque cardíaco. Desplácese por las miniaturas para ver el tema y la opción de descarga de cada clip.
Después del 9 de junio del 2026, consulte el manuscrito en línea en Circulation.
Guideline Hub for Professionals de la American Heart Association (cuando se permita la divulgación)
Siga las noticias de la American Heart Association/American Stroke Association (Asociación Americana del Derrame Cerebral) en X @HeartNews
Siga las noticias de Circulation, la revista médica insignia de la AHA, en @CircAHA
###
Acerca de la American Heart Association
La American Heart Association es una fuerza incansable para un mundo de vidas más largas y saludables. La organización ha sido una fuente líder de información sobre salud durante más de cien años y su objetivo es garantizar la equidad en la salud en todas las comunidades. Con el apoyo de más de 35 millones de voluntarios en todo el mundo, financiamos investigaciones vanguardistas, defendemos la salud pública y proporcionamos recursos fundamentales para salvar y mejorar vidas afectadas por enfermedades cardiovasculares y ataques o derrames cerebrales. Trabajamos incansablemente para hacer avanzar la salud y transformar vidas cada día mediante el impulso de avances y la implementación de soluciones comprobadas en las áreas de ciencia, políticas y cuidados. Comuníquese con nosotros en heart.org (sitio web en inglés), Facebook o X, o llame al 1-800-AHA-USA1.
Para consultas de los medios de comunicación:214-706-1173
People and health care professionals treat these conditions separately, but they’re deeply connected. For the first time, a clinical guideline addresses the connection.
Highlights
The first guideline for cardiovascular-kidney-metabolic syndrome (CKM syndrome), published today by American Heart Association and the American College of Cardiology, identifies obesity as a key metabolic factor in the syndrome’s development and progression.
The guideline urges earlier, prevention-focused conversations about weight and metabolic health.
The guideline says that using navigators or care coordinators improves care by helping coordinate care between the patient, primary care and specialty clinicians.
Embargoed until 1 p.m. CT/2 p.m. ET Tuesday, June 9, 2026
DALLAS, June 9, 2026 — The first-ever clinical guideline for cardiovascular-kidney-metabolic syndrome, or CKM syndrome, identifies excess weight, especially in the abdomen, as a key driver for the syndrome. The guideline aims to make people more aware of how heart disease, kidney disease and metabolic conditions (including diabetes and obesity) are interconnected.
As obesity rates continue to rise, the guideline underscores supporting a healthy weight and calls on healthcare professionals to begin prevention-focused conversations with their patients about how managing weight now can help prevent future health problems.
“In terms of CKM health, weight is not just about a number on a scale — people with the same body weight can have very different health profiles,” said Chiadi E. Ndumele, M.D., Ph.D., an American Heart Association volunteer and chair of the writing committee for the new guideline, which is jointly issued by the American Heart Association and the American College of Cardiology. “Rather, what’s most important is how fat tissue affects your metabolic health. This includes how your body manages blood sugar levels and how fat is used and stored.”
The CKM syndrome guideline replaces the 2013 guideline for managing overweight and obesity issued by the Heart Association and other societies.
CKM syndrome first was defined by the American Heart Association in 2023.
“CKM syndrome is a real, rising public health threat,” said Ndumele, who is director of obesity and cardiometabolic research at Johns Hopkins University in Baltimore.
He noted that while many people may have been told they have heart disease or kidney disease or diabetes, they may not know how closely all of these conditions are connected. Having one increases the risk of having others, a common challenge in CKM syndrome. Having obesity also raises that risk.
“The challenge is how to connect the recommendations from different clinicians who may specialize in only one of these conditions.,” he said. “So, we are trying to help clinicians from various specialties all speak in a common language and be on the same page, especially when it comes to managing weight and its clinical consequences.”
“Maintaining a healthy weight has long been seen as essential to heart health and preventing other chronic illness. However, doctors don’t always raise the topic of weight unless a patient brings it up, and often the focus is on appearance rather than health,” said Ambar Kulshreshtha, M.D., Ph.D., a volunteer member of the Heart Association’s Council on Quality of Care and Outcomes Research and a primary care physician who also helped write the new guideline.
The new guideline gives healthcare professionals a reason for discussing weight – not as a cosmetic issue, he said, but as a risk factor that can lead to organ damage.
“We are saying that prevention is as important, if not more important, than treatment,” said Kulshreshtha, who is an associate professor in the department of family and preventive medicine at the Emory School of Medicine in Atlanta.
In medical terms, the problem with having overweight or obesity is when fat tissue accumulates in the belly and clings to organs in the abdomen. Such fat can cause inflammation, which leads to insulin resistance and problems with the way blood vessels dilate and contract.
As these issues persist, CKM syndrome progresses to include diabetes, kidney disease and eventually organ damage that may include kidney failure, heart failure, liver disease, heart attacks or strokes.
If caught early, however, the disease process in CKM syndrome can be stopped or even reversed.
When explaining CKM syndrome to his own patients, Kulshreshtha likens the body’s blood vessels to plumbing in a house. Obesity causes inflammation, which he compares to rust.
“The rust can damage the pipes, which is like your vascular system,” he said. “It can damage the pump, which is like your heart. And it can damage the filters, like your kidneys.”
Ndumele said the guideline offers ways for healthcare professionals to discuss weight in non-judgmental ways. “It starts with a question of, ‘Is now a good time for us to address your weight and your health and how they may be affecting each other?’”
The idea is to stop hard-to-treat problems before they start.
“The multiple consequences of obesity include diabetes, chronic kidney disease and cardiovascular disease. The guideline provides healthcare professionals with approaches for identifying and managing these conditions,” Ndumele said. “I think every clinician knows of patients with these conditions. They’re often in and out of the hospital, and we share the patient’s frustration in managing multiple conditions and trying to stay healthy.”
Excess weight increases the risk of heart disease and stroke by at least 21% for men and 32% for women, according to the American Heart Association. In addition, each 5-unit increase in body mass index (BMI) is associated with a 41% higher risk of heart failure.
Early conversations and “an increasing array of tools,” Ndumele said, can keep people from getting to those dangerous stages or even reverse CKM syndrome in its early forms.
“The guideline includes proven strategies to support healthy lifestyle practices as the foundation of CKM syndrome management,” he said. “It also outlines the use of increasingly effective medications that benefit multiple body systems. These include SGLT2 inhibitors, GLP-1 based therapies and nonsteroidal mineralocorticoid receptor antagonists. We want people in the community to be more aware of the fact that, ‘Hey, there's a process here,’ and that if there's intervention earlier, ‘I can dramatically improve my long-term outcomes.’”
In addition to changing how clinicians talk to patients about weight, the guidelines offer general principles to improve the way healthcare professionals work together to address obesity, diabetes, chronic kidney disease and heart disease.
“We, as either primary care clinicians or sub-specialists, operate from our own silos,” said Fatima Rodriguez, M.D., M.P.H., vice-chair of the guideline writing committee and chief of preventive cardiology at Stanford University. “But people with CKM syndrome don’t experience one condition at a time — it often all hits at the same time.”
She said that working with other members of the healthcare team means patients are treated as a whole person.
“People appreciate being seen and treated holistically,” she said. “The idea is that patient care is a team effort, and the patient is team captain.”
The guideline outlines the benefits of using CKM coordinators, or navigators, to coordinate care between the different healthcare professionals and patients, and to ensure follow-up care. As part of whole-person care, the guideline also emphasizes identifying social barriers to healthy lifestyle and quality healthcare, and providing social support as needed.
“Research has shown that interdisciplinary teams make a dramatic impact on how people feel about their care and on how successful treatment is,” Ndumele said. “Our goal here is to shift some of our paradigms, to not just wait for the disease to come to us, but rather to help individuals prevent a lot of disease in the long term.”
In 2024, the American Heart Association launched the CKM Health Initiative to provide a path forward for patients, communities and healthcare professionals to improve diagnosis and treatment for CKM syndrome. Learn more about it on the initiative’s page at heart.org.
The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.
Additional Resources:
Available multimedia is on right column of release link, including video interview clips with Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA,Fátima Rodriguez, M.D., M.P.H., FAHA, FACC and Claudia Mercado, heart attack survivor. Scroll through thumbnails for each clip topic and download option.
Follow American Heart Association/American Stroke Association news on X @HeartNews
Follow news from the AHA’s flagship journal Circulation@CircAHA
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
The clinical staging for cardiovascular-kidney-metabolic (CKM) syndrome, risk factor screening, and prevention and treatment strategies are detailed in a new joint guideline from the American Heart Association and the American College of Cardiology
Guideline Highlights:
The first-ever clinical practice guideline on cardiovascular-kidney-metabolic (CKM) syndrome from the American Heart Association and the American College of Cardiology details staging to assess how a person’s kidneys, metabolism and heart are functioning. Higher stages of CKM syndrome are associated with a greater burden of serious health conditions, such as Type 2 diabetes, chronic kidney disease, and a higher risk of cardiovascular disease and mortality.
The guideline reviews CKM syndrome risk factors including overweight/obesity, pre-diabetes/Type 2 diabetes, high blood pressure and abnormal lipids, as well as chronic kidney disease.
Comprehensive recommendations include screening, prevention and treatment for people with or at risk of developing CKM syndrome. Healthy lifestyle behaviors; medications, including GLP-1-based therapies and SGLT2 inhibitors; and/or metabolic and bariatric surgery, when appropriate, are recommended with the goal of preventing, managing and potentially reversing CKM syndrome progression.
Embargoed until 1:00 p.m. CT/2:00 p.m. ET Tuesday, June 9, 2026
DALLAS and WASHINGTON, June 9, 2026 — The American Heart Association and the American College of Cardiology, along with two other leading medical organizations have developed the first-ever guideline aimed at preventing and managing cardiovascular-kidney-metabolic (CKM) syndrome, an interconnected set of health conditions that significantly increase the risk of multiorgan complications and negative cardiovascular outcomes. Nearly 90% of U.S. adults have at least one CKM syndrome risk factor, including excess weight, high blood pressure, abnormal lipids, high blood glucose (sugar) or reduced kidney function.
Recommendations to help clinicians and individuals identify CKM syndrome risk earlier and take action to protect long-term heart, metabolic and kidney health are detailed in this new clinical practice guideline, published today in the American Heart Association’s flagship peer-reviewed journal Circulation and in JACC, the flagship journal of the American College of Cardiology.
According to recent statistics from both the American Heart Association and the American College of Cardiology, 40% of U.S. adults and 21% of children and adolescents in the U.S. have obesity, defined as excess body fat that presents a risk to health. Obesity is a risk factor for high blood pressure, Type 2 diabetes, metabolic dysfunction, cardiovascular disease and kidney disease.
“Heart, kidney, and metabolic conditions don’t occur in isolation—they are deeply connected,” said Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA, chair of the guideline writing committee and the director of obesity and cardiometabolic research at Johns Hopkins School of Medicine in Baltimore. “This guideline calls for earlier screening and care, focusing on prevention and coordinated action to reduce the risk of cardiovascular disease before serious complications develop or a major cardiac event occurs.”
What are the stages of cardiovascular-kidney-metabolic (CKM) syndrome?
There are four stages of CKM syndrome. These stages identify risk and tailor prevention strategies to slow—or even reverse—progression of CKM syndrome:
Stage 1: individuals with overweight/obesity or prediabetes, but without other metabolic risk factors, kidney disease or cardiovascular disease
Stage 2: includes people with one or more metabolic risk factors (such as high blood pressure, abnormal lipid levels, Type 2 diabetes or metabolic syndrome) and/or kidney disease, but without cardiovascular disease
Stage 3: people with subclinical (asymptomatic) cardiovascular disease and CKM risk factors; or those with the risk equivalents of very-high-risk chronic kidney disease or high predicted 10-year risk of cardiovascular disease (based on the PREVENT-CVD equations)
Improved risk assessment using the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations to estimate 10- and 30-year risk for cardiovascular disease, which can help guide individualized lifestyle and treatment plans. PREVENT includes kidney and metabolic health factors in the equations for a more comprehensive and precise estimation of risk compared with previous tools.
Screening for social factorsthat affect health, including food insecurity, housing instability and financial strain, is also recommended to identify individuals at higher risk of developing CKM syndrome.
Coordinated interdisciplinary care and healthy lifestyle behaviors, including attention to physical activity, nutrition, weight, blood pressure, blood sugar and cholesterol, are emphasized to prevent and manage CKM syndrome.
In conjunction with lifestyle management, additional treatment options for CKM syndrome include medications and surgical therapies, such as medications to manage blood pressure, cholesterol, blood sugar and weight, to protect the heart and kidneys. For the first time, GLP-1-based therapies are recommended for select individuals with obesity and/or Type 2 diabetes, and other risk factors for cardiovascular disease to reduce the risk of cardiac events. Metabolic and bariatric surgery may also be used to treat CKM syndrome.
What should people do to prevent CKM syndrome?
The guideline underscores that lifestyle modification can make a meaningful difference in overall health. Taking action early can help prevent a heart attack, heart failure, stroke or kidney failure. Individuals are encouraged to follow the American Heart Association’s Life’s Essential 8, measures recommended to improve and maintain cardiovascular health.
“Life’s Essential 8 focuses on regular physical activity, heart-healthy eating, maintaining a healthy weight, managing blood pressure, blood sugar and cholesterol, as well as avoiding tobacco and getting enough quality sleep. These are all powerful tools to improve cardiovascular-kidney-metabolic health,” said Fátima Rodriguez, M.D., M.P.H., FAHA, FACC, vice chair of the writing committee and an associate professor of cardiovascular medicine at Stanford Medicine in Stanford, California. “These actions reduce the risk of heart disease and also support kidney and metabolic health across the lifespan.”
The guideline, led by the American Heart Association and the American College of Cardiology Joint Committee on Clinical Practice Guidelines, was developed in collaboration with and endorsed by the American Diabetes Association; the American Diabetes Association Obesity Association; and the American Society of Nephrology. Members of the guideline writing committee and authors’ disclosures are listed in the manuscript.
The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.
Additional Resources:
Available multimedia is on right column of release link, including video interview clips with Chiadi E. Ndumele, M.D., Ph.D., M.H.S., FAHA,Fátima Rodriguez, M.D., M.P.H., FAHA, FACC and Claudia Mercado, heart attack survivor. Scroll through thumbnails for each clip topic and download option.
American Heart Association/American College of Cardiology Scientific Statement: Use of Risk and Benefit to Guide Decision-Making for CKM Therapies in the Primary Prevention of CVD in Circulation and JACC (at embargo lift – 2 p.m. ET, June 9, 2026)
Follow news from the American Heart Association’s flagship journal Circulation@CircAHA
Follow news from the ACC’s flagship journal JACC @JACCJournals
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
About the American College of Cardiology
The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or follow @ACCinTouch.
Physical activity, an essential component of any weight loss program, also supports overall heart and metabolic health, according to a new scientific statement from the American Heart Association
Statement Highlights:
Regular physical activity improves blood pressure, insulin sensitivity, cholesterol levels and cardiorespiratory fitness in adults with overweight or obesity, independent of weight loss, according to a new scientific statement from the American Heart Association.
Physical activity is an essential part of effective obesity treatment, likely adding health benefits even with weight-loss medications or surgery, strengthening results when used alongside today’s treatments.
Long‑term success with weight loss depends on team‑based support, with clinicians and other health professionals helping people build and maintain realistic health habits.
Embargoed until 4 a.m. CT/5 a.m. ET, Monday, June 1, 2026
DALLAS, June 1, 2026 — With obesity now affecting more than 40% of U.S. adults and fueling rising rates of heart disease, a new scientific statement from the American Heart Association calls for a comprehensive treatment approach that puts physical activity front and center. The statement, Role of Physical Activity in Obesity Treatment and Cardiometabolic Health, published today in Circulation, the Association’s flagship, peer‑reviewed journal.
The statement underscores that regular physical activity improves blood pressure, insulin sensitivity, cholesterol levels and cardiorespiratory fitness in adults with overweight or obesity, independent of weight loss. These findings support the need for exercise as a critical component to any weight loss strategy, including medications or surgery, because physical activity offers important cardiometabolic health benefits in its own right.
“Doctors and health professionals often focus on weight loss to help people lower their risk of heart disease. There are certainly health benefits from weight loss, especially when it’s sustained long-term. However, encouraging physical activity should always be an important part of that care plan, as it can support both weight loss and long-term maintenance,” said Damon L. Swift, Ph.D., FAHA, American Heart Association volunteer and chair of the writing group for the scientific statement and an associate professor of kinesiology at the University of Virginia in Charlottesville. “Physical activity delivers powerful heart and metabolic health gains even when the scale doesn’t move. These benefits are especially important because many people with overweight or obesity already have cardiovascular risk factors.”
How much exercise do I need?
“For most people, cardio exercise without changing your diet is unlikely to result in a large amount of weight loss. Dietary changes remain the primary driver of weight loss,” Swift said. “However, physical activity plays a powerful supporting role when combined with other treatments, including healthy eating, weight loss medications or surgery. Exercise can help people lose a little more weight, preserve important lean mass — especially with resistance exercise — and improve overall health.”
Swift said when people lose weight by cutting calories, they often lose muscle, too. Studies show that adding exercise to dietary weight loss helps people preserve more muscle compared with dieting alone. Strength or resistance training appears especially effective, particularly for middle-aged and older adults. Eating at least the recommended daily amount of protein also helps the body maintain muscle while losing fat. Keeping muscle isn’t just about strength, it helps with mobility, metabolism, and blood sugar control.
On its own, exercise usually does not lead to clinically meaningful weight loss unless people are able to be active for very long periods each week.
The scientific statement highlights that exercise by itself rarely leads to any more than a 5% or more loss in body weight unless aerobic activity levels are quite high, at least 225–420 minutes per week.
Fewer than 15% of individuals reach a clinically significant amount of weight loss through exercise alone. Modest weight loss of around 3% (and less than 5%) of body weight is more achievable and does support some health benefits.
According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, most people in the U.S. are not getting an adequate amount of physical activity for any health benefits, much less weight loss.
Only 1 in 4 U.S. adults and 1 in 5 youths 6 to 17 years of age meet national recommendations for being physically active.
The American Heart Association recommends that adults achieve a minimum of 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity. To maximize health outcomes, these aerobic guidelines should be paired with muscle-strengthening activities of at least moderate intensity on two or more days per week. Adherence to these physical activity levels with significant improvements in heart disease risk factors and a marked reduction in all-cause and cardiovascular mortality.
Why do I have to keep exercising after I reach my goal weight?
Swift said maintaining weight loss is often more difficult than achieving it. The statement highlights strong evidence that high levels of consistent physical activity — often 200 to 300 minutes per week of moderate-intensity physical activity— are associated with long‑term weight‑loss maintenance and that is considerably more than the 150 minutes per week recommended by the American Heart Association for cardiovascular health.
However, if you cannot reach those levels, it is still beneficial to maintain a regular schedule with some exercise and stay as active as you can. Doing any physical activity is much better than doing nothing.
“Many of the health benefits achieved from weight loss may be reversed if the weight is gained back,” he said. “Physical activity can not only help maintain weight loss, it also may protect cardiovascular health even if some weight regain occurs, helping preserve earlier improvements in blood pressure and insulin sensitivity.”
What does successful treatment of obesity look like?
“As with any major medical issue, treatment of obesity should be individually tailored to a person’s specific needs and usually requires a comprehensive, multipronged approach that’s best achieved with guidance from a health professional,” Swift said. “Not only does this support individual accountability, but just as you wouldn’t likely treat high blood pressure or diabetes on your own, optimal results in treating obesity will come from a collaboration with your clinician and health care team.”
Because long‑term success depends on ongoing support, the statement emphasizes the role of clinicians and health care professionals to help people address obesity by setting realistic goals, staying motivated and using evidence-based approaches including medications or surgery, counseling and digital tools. Treatment plans should consider strong physician-patient communication, comprehensive medical assessments and plans for follow-up care.
The statement highlights the 5A model as one option to successfully encourage regular physical activity participation:
Assess: Uncover the individual’s intention to engage in and knowledge of increased physical activity.
Advise: Offer information to further the individual’s understanding of approaches to incorporate regular physical activity into their day.
Agree: Collaborate on establishing SMART goals which are:
Specific,
Measurable,
Achievable,
Relevant and
Time bound.
Assist: Collaborate on problem-solving and strategies to achieve a SMART goal.
Arrange: Work on plans to review progress and to provide references for additional support.
Incorporating physical activity into an obesity treatment plan may include a wide range of options:
Appropriate clinical interventions such as weight loss medication or surgery
Referrals to physiotherapists, physical therapists or exercise physiologists
Consultations with other auxiliary health care professionals such as nurses/nurse practitioners, registered dietitians, health educators/coaches or behavioral counselors
Use of technology including electronic health records, cost-effective pedometers and digital technologies such as mobile health applications and wearables (such as smartwatches or adhesive patches with sensors) for real-time monitoring to support or facilitate lifestyle changes.
“Despite the known benefits of physical activity, many people face challenges being active, including time constraints and limited access to safe or convenient ways to move during daily routines. Addressing these barriers can help support healthier habits over time,” said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association and executive director of the Katz Institute for Women’s Health and senior vice president of women’s health at Northwell Health in New York City. “The American Heart Association supports evidence-based public health policies that integrate physical activity assessment, prescription and referral into health care delivery and help make physical activity easier and more accessible for people of all ages and abilities. Research shows that safe community design, opportunities for activity in schools and in the workplace, along with access to active transportation can all increase daily movement and support long-term cardiovascular and metabolic health.”
“For many people, lasting weight loss can feel out of reach. When movement is added as part of obesity care, it not only supports weight loss goals, but improves key health risk factors,” Swift said. “Physical activity should be prescribed and prioritized for its cardiovascular and metabolic benefits in obesity treatment. Exercise can help you be healthier even if you don’t lose weight.”
This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Hypertension;
and Stroke Council. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.
Co-authors are Leanna M. Ross, Ph.D., FAHA, Vice Chair; Deepika R. Laddu, Ph.D., FAHA;
Molly B. Conroy, M.D., M.P.H., FAHA; Charles A. German, M.D., M.S., FAHA; Lorraine S. Evangelista, Ph.D., R.N., FAHA; Francoise A. Marvel, M.D.; and Gerald J. Jerome, Ph.D., FAHA. Authors’ disclosures are listed in the manuscript.
The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.
More than 8 in 10 (82%) U.S. adults say they are confident in the American Heart Association to provide trustworthy information related to public health, according to a recent Annenberg Policy Center poll. The Association ranked second only to an individual’s personal health care provider.
Additional Resources:
Additional multimedia are on right column of release link.
The American Heart Association’s Heart on the Move Challenge, is a 21-day, step-based program to help people build a consistent movement routine in a way that fits into daily living.
Follow American Heart Association/American Stroke Association news on X @HeartNews
Follow news from Circulation, the American Heart Association flagship journal on X @CircAHA.
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
