Abstract: FR-PO383
Association between Cardiovascular-Kidney Metabolic (CKM) and Mortality in a Middle- and Older-Aged Asian Population
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Sabanayagam, Charumathi, Singapore Eye Research Institute, Singapore, Singapore
- Thyagarajan, Pavitra, Singapore Eye Research Institute, Singapore, Singapore
- Ji, Hongwei, Tsinghua University, Beijing, Beijing, China
- Lim, Cynthia Ciwei, Singapore General Hospital, Singapore, Singapore
- Wong, Tien Yin, Singapore Eye Research Institute, Singapore, Singapore
- Cheng, Ching-Yu, Singapore Eye Research Institute, Singapore, Singapore
Background
Cardiovascular-kidney metabolic (CKM) Syndrome is recognized by the American Heart Association (AHA) to encompass the interplay among metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). We examined the association between CKM syndrome and all-cause mortality in an Asian population.
Methods
Data for this study was derived from a sample of Chinese, Malay and Indian participants aged 40-80 years (n=6957, men=51.7%) who attended the baseline visit (2004-2011) of the Singapore Epidemiology of Eye Diseases (SEED) study, a population-based cohort study in Singapore. The primary outcome was all-cause mortality obtained by linkage to death registry until 2021. CKM stages (0-4) were defined according to the AHA criteria. As there were few participants in stage 3 (n=31), we combined stages 3 and 4 for analysis. Associations between CKM stages and mortality were assessed using Cox-proportional hazards regression models adjusted for age, sex, and ethnicity, both in the overall population and stratified by sex.
Results
During follow-up (median, 11.8 years), 882 participants died. Most participants were categorized under stage 2 CKM, with prevalence across stages are as follows: 3.2% (stage 0), 7.2% (stage 1), 83.3% (stage 2), and 6.3% (stage 3-4). All-cause mortality was 12.7% (9.3% in women vs. 15.9% in men). CKM stage-specific mortality rates in the overall population were 4.0%, 4.4%, 11.6% and 40.2%. Women had significantly lower mortality than men in all stages (p<0.05). In multivariable analysis, compared to stage 0, stage 3-4 CKM showed significant association with all-cause mortality with hazard ratio (HR) (95% confidence interval) of 2.74 (1.39 - 5.38). Sex-specific analysis revealed significant association in stage 3-4 in men only, 2.86 (1.25 - 6.51).
Conclusion
Our findings showed that higher stages of CKM were associated with increased mortality among middle-aged and older Asian adults, particularly in men. Understanding these associations aids in risk stratification and targeted interventions for improved cardiovascular and kidney health outcomes.