Evolving Landscape for Managing Cardiovascular, Renal and Metabolic Conditions

Boehringer Ingelheim's Brian Hilberdink and Neerja Balachander discuss the evolving landscape of managing cardiovascular, renal and metabolic conditions. Despite decades of innovation, significant work remains in the cardio-renal-metabolic space. Cardio-kidney-metabolic conditions affect over a billion patients worldwide and are the leading cause of mortality and morbidity, with 90% of adults in the US affected by at least stage one of these conditions.

The focus on cardio-kidney-metabolic conditions has shifted from diabetes meetings to obesity meetings, chronic kidney disease meetings, and MASH meetings. This shift is due to the realization that diseases are not siloed and should be treated together, with guidelines from the WHO, AHA, and ACC aligning with this approach.

A key component of this shift is the Detect the SOS campaign, which aims to educate patients about the early stages of cardiovascular risk factors, such as elevated microalbuminuria, which often precede a decrease in eGFR. However, only 10% of the 35 million Americans living with CKD are aware of their condition, as microalbuminuria is not part of standard metabolic panels.

The discussion also highlights the importance of understanding obesity as a metabolic disease, rather than a matter of personal responsibility. Obesity affects more than 200 comorbid conditions and is associated with prediabetes, insulin resistance, and hypertension. Medical professionals must move away from stigmatizing language and recognize the role of the liver in metabolic-associated liver disease (MASLD) in patients with obesity.