Novel Cardiometabolic Medications in the Cardiovascular-Kidney-Metabolic Syndrome Era

Abstract

Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay of obesity, hypertension, hyperlipidemia, type 2 diabetes mellitus, chronic kidney disease, and cardiovascular disease, driving elevated morbidity and mortality. CKM syndrome encompasses a continuum of interrelated metabolic, renal, and cardiovascular dysfunctions attributed to obesity, impaired glucose regulation, and chronic inflammation. This review synthesizes recent literature on the efficacy of cardiorenal protective medications including sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in CKM syndrome management. Sodium-glucose cotransporter 2 inhibitor agents show promising outcomes, including reduced cardiovascular mortality, hospitalization for heart failure, and adverse kidney events across diverse patient populations, regardless of type 2 diabetes mellitus status. Similarly, glucagon-like peptide-1 receptor agonist agents demonstrate substantial benefits in weight loss, glycemic control, and reduced cardiovascular and kidney events. The review also highlights the necessity of equitable pharmacotherapy distribution to ensure that high-risk populations benefit from these advancements and the need for further precision-based therapeutic frameworks, policy innovations, and tailored interventions focused on CKM syndrome management. Finally, we discuss strategies for translating these findings into practice through an equity-focused lens to advance CKM health.

Keywords: cardiovascular disease; cardiovascular-kidney-metabolic syndrome; kidney disease; obesity; type 2 diabetes mellitus.