Research Square · Oct 19, 2026
Prevalence and Population Burden of 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 factors, kidney disease, and cardiovascular disease into progressive stages. However, the national distribution and population burden of CKM stages in Mexico are unknown. We estimated the prevalence and corresponding population size of each CKM stage among Mexican adults. Methods We conducted a cross-sectional analysis of the 2018–2019 Mexican National Health and Nutrition Survey. The analytical sample included 10,522 adults aged ≥ 20 years from the fasting serum subsample. Participants were classified into mutually exclusive CKM stages 0–4 using a hierarchical algorithm based on the current CKM staging framework and adapted to the survey variables available. Classification incorporated anthropometry, glycaemia, blood pressure, lipids, estimated glomerular filtration rate, PREVENT-CVD risk, and self-reported clinical cardiovascular disease. Survey weights were recalibrated to national population margins, and design-based prevalence estimates, 95% confidence intervals, and population counts were calculated. Results The analytical sample represented 82.16 million Mexican adults. Stage 2 was the most prevalent category, affecting 60.8% (95% CI 59.2–62.4%), or approximately 49.95 million adults. The prevalences of stages 0, 1, 3, and 4 were 10.4%, 21.3%, 3.7%, and 3.8%, respectively. Overall, 89.6% (95% CI 88.5–90.6%), representing 73.58 million adults, met criteria for CKM stages 1–4, while advanced CKM syndrome (stages 3–4) affected 7.5% (6.6–8.3%), or 6.13 million. Among adults aged 20–44 years, 83.7% had CKM stages 1–4 and 54.1% were already in stage 2. Allowing triglycerides ≥ 150 mg/dL to independently qualify for stage 2 increased its prevalence to 69.1%, whereas the prevalence of any CKM syndrome increased more modestly to 91.8%. Conclusions Nearly nine in ten Mexican adults met criteria for CKM syndrome, with the burden concentrated in stage 2 and already evident in early adulthood. These estimates identify substantial population needs for integrated metabolic, kidney, and cardiovascular prevention and provide a national baseline for CKM surveillance and health-system planning in Mexico.