Journal of Epidemiology and Global Health · Nov 10, 2026
Prevalence and Population Burden of Operational Cardiovascular-Kidney-Metabolic Syndrome Stages Among Mexican Adults: A Nationally Representative Cross-sectional Study
By Silva-Tinoco R, Avalos-Bracho A, Rivas-Alarcón AA et al.
Background The cardiovascular-kidney-metabolic (CKM) framework integrates adiposity, metabolic risk, kidney risk, and cardiovascular disease into stages spanning risk factors to clinically manifest disease. Nationally representative operational CKM estimates are unavailable for Mexico. We estimated the prevalence and population burden of each stage among Mexican adults. Methods We conducted a cross-sectional analysis of the 2018–2019 Mexican National Health and Nutrition Survey. The analytical sample comprised 10,522 nonpregnant adults aged ≥ 20 years from the fasting serum subsample. Mutually exclusive operational stages 0–4 were assigned hierarchically using the current CKM framework and measured anthropometry, glycaemia, blood pressure, lipids, estimated glomerular filtration rate (eGFR), PREVENT-CVD risk, and self-reported cardiovascular disease. Mexican-surveillance waist thresholds (≥ 80 cm in women; ≥90 cm in men), absence of albuminuria and direct subclinical cardiovascular measurements, and restriction of PREVENT-CVD to validated ages and predictor ranges were prespecified operational considerations. Survey weights were recalibrated to national population margins. Results The sample represented 82.16 million nonpregnant Mexican adults in 2018–2019. Stage 2 was the most prevalent category (69.1%; 95% CI, 67.6–70.7%), corresponding to 56.78 million adults, while stages 1–4 collectively affected 91.6% (95% CI, 90.7–92.6%). The prevalence of stages 1–4 was 92.4% in women and 90.8% in men, and 87.1%, 97.0%, and 98.0% among adults aged 20–44, 45–64, and ≥ 65 years, respectively. Notably, stage 2 alone affected 64.7% of adults aged 20–44 years. Conclusions Most Mexican adults had at least one adiposity, metabolic, kidney-risk, or cardiovascular characteristic that placed them in operational CKM stages 1–4, with stage 2 predominating and already common among younger adults in 2018–2019. These descriptive estimates provide a nationally representative baseline for integrated surveillance and population-level assessment of prevention, evaluation, and healthcare needs, and may inform health-service planning in Mexico.