Heart Lung Circ. 2025 Sep 2:S1443-9506(25)01507-0. doi: 10.1016/j.hlc.2025.06.1017. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses cardiovascular disease, chronic kidney disease, and metabolic disorders. However, its association with depression across different stages remains unclear.
METHOD: We analysed 4,097 adults from National Health and Nutrition Examination Survey 2005-2020. Depression was assessed using the Patient Health Questionnaire-9, and CKM stages were classified according to the 2023 American Heart Association guidelines. Survey-weighted multivariable logistic regression was used to examine associations, with subgroup and sensitivity analyses.
RESULTS: The odds of depression increased progressively with CKM severity, with the highest risk observed in Stage 4 (odds ratio [OR] 1.112; 95% confidence interval [CI] 1.039-1.190; p=0.003). Significant associations were also found in Stages 2 and 3. Subgroup analyses revealed stronger associations in females (OR 1.180; 95% CI 1.053-1.322; p=0.005), older adults (OR 1.125; 95% CI 1.081-1.171; p<0.001), Mexican Americans (OR 1.260; 95% CI 1.118-1.419; p<0.001), and individuals with low education (OR 1.463; 95% CI 1.302-1.644; p<0.001).
CONCLUSIONS: Advancing CKM stage is significantly associated with increased depression risk, particularly among vulnerable sociodemographic groups. These findings highlight the need for integrated mental health strategies in managing CKM syndrome.
PMID:40903381 | DOI:10.1016/j.hlc.2025.06.1017
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