People with advanced heart, kidney and metabolic disease may face a higher risk of developing cancer, according to new research published today in the American Heart Association's peer-reviewed scientific journal Circulation: Population Health and Outcomes. The study examined nearly 1.4 million adults and found that later stages of cardiovascular-kidney-metabolic (CKM) syndrome were linked to a 25-30% higher risk of cancer.
CKM syndrome, defined by the American Heart Association, encompasses interconnected conditions such as heart disease, stroke, kidney disease, obesity and diabetes. According to the Association, nearly 9 out of 10 adults in the U.S. have at least one component of CKM syndrome, including high blood pressure, abnormal cholesterol, high blood glucose, excess weight or reduced kidney function. The syndrome is staged from 0 (no risk factors) to 4 (established cardiovascular disease).
Researchers at the University of Tokyo in Japan analyzed national insurance claims data to classify participants by CKM stage and tracked them for an average of 3.5 years, noting new cancer diagnoses. Compared to healthy individuals (stage 0), those in stage 1 had a 3% higher risk, stage 2 had a 2% higher risk, stage 3 had a 25% higher risk, and stage 4 had a 30% higher risk of developing cancer.
“The study findings suggest that it is important to consider not only cardiovascular disease risk, but also cancer risk in people with CKM syndrome,” said lead author Hidehiro Kaneko, M.D., Ph.D., associate professor in the department of cardiovascular medicine at the University of Tokyo. “CKM syndrome represents a complex interplay among the cardiovascular, kidney and metabolic systems, where dysfunction in one area may trigger or exacerbate dysfunction in others.”
The research underscores the concept of reverse cardio-oncology, where cardiovascular disease and its risk factors increase cancer risk. “We already know that cancer and its therapies can lead to cardiotoxicities and cardiovascular disease,” said Tochukwu Okwuosa, D.O., director of cardio-oncology services at Rush University Medical Center and an American Heart Association volunteer. “The study highlights the bidirectional relationship and underscores the concept of reverse cardio-oncology where cardiovascular disease and its risk factors also increase cancer risk.”
While the study was limited to a Japanese population, the authors noted that other studies have consistently reported links between metabolic and kidney dysfunction and increased cancer risk, suggesting the findings may apply more broadly. The CKM syndrome staging framework could help identify high-risk individuals for potential cancer screenings.
The American Heart Association's CKM Health Initiative aims to address these interconnected conditions. More information on CKM syndrome can be found in the Association's presidential advisory on cardiovascular-kidney-metabolic health.
