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Cardiovascular Kidney Metabolic Syndrome
Context:
The CKM (Cardiovascular-Kidney-Metabolic) syndrome is emerging as a significant global health issue, often referred to as the “price of modernity.”
What is CKM Syndrome?
- CKM Syndrome is a complex and multifaceted health condition that has emerged as a significant concern in modern healthcare.
- This syndrome is characterised by the interplay of cardiovascular disease, chronic kidney disease, type 2 diabetes, and obesity.
- The intricate relationship between these conditions is influenced by both lifestyle factors and the broader impact of globalisation.
- Symptoms: Include chest pain, shortness of breath, fatigue, swelling in the legs, frequent urination, and unexplained weight gain.
- Diagnosis: Typically involves a combination of medical history, physical examination, blood tests, and imaging studies.
- Prevention: Involves promoting healthy lifestyle choices from an early age, including a balanced diet, regular exercise, and avoiding tobacco and excessive alcohol consumption.
- Public health initiatives and education campaigns can play a crucial role in raising awareness and encouraging preventive measures.
Key Components:
- Cardiovascular Disease: This includes conditions such as hypertension, coronary artery disease, and heart failure.
- Chronic Kidney Disease: Impaired kidney function that can progress to end-stage renal disease.
- Type 2 Diabetes: A metabolic disorder characterised by high blood sugar levels due to insulin resistance.
- Obesity: The modern sedentary lifestyle, coupled with the availability of high-calorie, processed foods, has led to a rise in obesity rates, setting the stage for CKM Syndrome.
Causes and Risk Factors:
- Lifestyle Factors: Poor diet, lack of physical activity, smoking, and excessive alcohol consumption are significant contributors.
- Genetic Predisposition: Family history of any of the component conditions increases the risk.
- Globalisation: The adoption of Western dietary patterns and sedentary lifestyles has contributed to the rise of CKM Syndrome globally.
Global Impact:
- The Global Burden of Disease (GBD) report highlights the mounting burden of non-communicable diseases (NCDs), which account for 69% of premature deaths and 68% of years lost to disability.
- In regions like Tamil Nadu, despite a strong public health framework, the markers of well-being are being challenged by the rising prevalence of CKM syndrome.
- The 2020 Tamil Nadu STEPS survey revealed that 28.5% of participants were overweight, 11.4% had obesity, 33.9% had hypertension, and 17.6% had diabetes.
Management and Treatment:
- Lifestyle Modifications: Adopting a healthy diet, increasing physical activity, quitting smoking, and reducing alcohol intake.
- Medications: Drugs to control blood pressure, blood sugar, cholesterol levels, and protect kidney function.
- Regular Monitoring: Frequent check-ups to monitor the progression of the conditions and adjust treatment plans accordingly.
Impacts:
- The economic impact of CKM syndrome is profound, with significant health expenditures required to manage the condition.
- In Tamil Nadu, nearly ₹1,200 crore is spent annually on insurance premiums under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), covering 1.4 crore families.
- The syndrome can lead to reduced productivity and increased absenteeism in the workforce, impacting economic growth.
- Socially, CKM Syndrome can exacerbate health disparities, particularly in low- and middle-income countries where access to healthcare and healthy lifestyle options may be limited.
Implications:
- A new paradigm is essential to address the CKM syndrome effectively.
- The American Heart Association emphasises the importance of integrated care for CKM, advocating for a shift from segmented care to unified, simultaneous management of risk factors.
- The Integrated Disease Surveillance Programme (IDSP) is a crucial initiative in India aimed at enhancing the public health delivery system through effective disease surveillance.
- Efforts to address CKM Syndrome must focus on both individual lifestyle changes and broader policy interventions. Public health campaigns promoting healthy eating, physical activity, and smoking cessation are essential.
- Additionally, policies that support the availability of healthy food options and create environments conducive to physical activity can help mitigate the impact of CKM Syndrome.
