Cardiometabolic disease is a serious and growing public health problem made up of an increasingly complex constellation of diseases that physicians must navigate. Cardiometabolic risk factors can entail everything from metabolic syndromes such as dyslipidemia, hypertension, obesity, insulin resistance and hyperglycemia, to behavioral factors such as physical inactivity, smoking and unhealthy diet, and even more genetic causes such as family history, age and gender. Cardiorenal metabolic syndromes, including microalbuminuria and reduced renal function, have recently been adopted into this greater defined sphere.

Ethnic/minority populations are at particular risk, according to a comprehensive review published in Cardiorenal Medicine¹. The review addresses cardiorenal metabolic syndrome and cardiometabolic risks in minority populations, noting that both are significant sources of morbidity and mortality in racial/ethnic minorities, as well as health care costs. “Recent dramatic improvements in life expectancy and health care have not occurred equitably, and disparities in quality care, morbidity, and mortality between whites and certain racial/ethnic minorities, including the white-black mortality gap, persist,” according to the authors.

It also provides recommendations on ways to better control these factors and effectively reduce cardiovascular disease in diverse populations and provide more coordinated care. Caring for patients across the spectrum of cardiometabolic risk requires an integrated, coordinated and interdisciplinary approach to patient care that is largely unprecedented, and as such the groups recommend use of the National Minority Quality Forum’s Disease-Based Index and Cardiometabolic Index, better tools and resources for patient-centered care and self-management, more aggressive advocacy against obesity, and more comprehensive treatment programs for cardiometabolic risk. “The costs of cardiovascular disease and cardiorenal metabolic syndrome disparities are tremendous and must be addressed through culturally appropriate lifestyle modification, therapeutic programs and public health initiatives,” the authors also note.

Many of these recommendations are already in development and/or discussion as part of the collaborative Cardiometabolic Health Alliance, made up of the ACC, the National Minority Quality Forum, the American Association of Clinical Endocrinologists and the Association of Black Cardiologists. Aimed at reducing acute events associated with cardiometabolic risk factors and disease, particularly among minorities and at risk populations, the Alliance is focused on developing the tools and resources to help physicians and patients address this growing issue. Led by ACC, the Cardiometabolic Health Alliance also has an online Cardiometabolic Disease Clinical Community featuring news articles, case challenges, hot topics, interactive discussions and important resources. In the near future ACC will be launching the Cardiometabolic Clinical Toolkit, which will help clinicians treat patients with or at risk for cardiometabolic disease based on the most recent evidence and practices. A Cardiometabolic Think Tank will also take place in June, bringing together expert stakeholders from across the care team (physicians, nurse practitioners, physician assistants, dieticians, patient educators and pharmacists) and from across various disciplines including cardiology, primary care and endocrinology for action-driven discussions around how to create an interdisciplinary approach to care that optimizes cardiometabolic management in the U.S.

With new reports coming out seemingly daily on the continued prevalence of diabetes, the ongoing obesity epidemic and the need for hypertension control, discussions around cardiometabolic disease aren’t going away. It’s an exciting time to be on the cutting edge of these discussions, with the goal of bringing together the entire medical profession to truly make a difference in cardiovascular care and prevention.

1. Ferdinand, KC, et al. Cardiorenal Metabolic Syndrome and Cardiometabolic Risks in Minority Populations. Cardiorenal Med. 2014;4:1–11.

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