AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Cardio-Kidney-Metabolic Syndrome Prevalence and Associated Factors in an Urban Cohort in Haiti
By Alexandre W, Ogyu A, Macajou KJGW et al.
Background: Cardio-kidney-metabolic (CKM) syndrome, a novel framework proposed by the American Heart Association (AHA) to characterize the interplay between metabolic risk factors, kidney dysfunction, and cardiovascular disease, remains poorly characterized in low-income countries like Haiti, despite an uptrend in cardiovascular-related mortality and morbidity. Research question: We aimed to estimate the age-standardized prevalence of CKM stages and compare sociodemographic, behavioral, and psychosocial characteristics between advanced and non-advanced CKM stages in the Haiti CVD cohort. Methods: This cross-sectional analysis included all participants enrolled in the Haiti CVD cohort (2019-2021), recruited through multistage random sampling. CKM stages (0-4) were defined according to AHA criteria. Pearson's chi-square test and the Wilcoxon rank-sum test were used to compare characteristics between participants with advanced CKM (Stages 3-4) and non-advanced CKM (Stages 0-2) at enrollment. Results: Among 2, 727 participants (59.0 % female; median age 42 (28, 55)), the age-standardized prevalence of CKM Stages 0 through 4 was 29.3% (95% CI, 27.2-31.6%), 14.1% (12.7-15.8%), 21.9% (20.1-24.0%), 20.2% (18.5-22.2%), and 14.5% (12.9-16.4%), respectively. Median age increased from 27 years (IQR 22-38) in Stage 0 to 57 years (IQR 45-64) in Stage 4 and was significantly higher in advanced versus non-advanced stages (54 [43-63] vs. 34 [25-47]; p<0.001). Lower educational attainment (primary or below) increased from 15% in Stage 0 to 63% in Stage 4 (26% vs. 58% in non-advanced vs. advanced; p<0.001). Female sex was disproportionately represented in stage 4 at 69% compared to 40% in stage 0. Female sex comprised a greater proportion of participants with advanced CKM stages than non-advanced stages (67% vs. 54%; p<0.001). Psychosocial burden also increased with stage severity: moderate-to-severe depression rose from 10% in Stage 0 to 21% in Stage 4, and high perceived stress from 13% to 19% (both p<0.001). Conclusion: In this large population-based cohort from Haiti, more than one-third of adults had advanced CKM syndrome. Advanced CKM stages were associated with older age, female sex, lower educational attainment, depression, and high perceived stress. Women had a disproportionate burden of advanced CKM stages across all age groups , highlighting the need for targeted prevention strategies, particularly among women in resource-limited settings.