Cardiovascular-renal-metabolic syndrome, or CRS syndrome, is estimated to affect 9 out of 10 adults in the United States. At the same time, about the same number of people have never heard of him, The Washington Post reports. Read about how this syndrome manifests itself and why different disorders are considered by American doctors as parts of the same spectrum.
The term “SCM syndrome” is a relatively recent term—the American Heart Association (AHA) described it in 2023, and guidelines for physicians were published only in June 2026.
SCM syndrome is not one specific disease, but a complex of disorders reflecting the close relationship between cardiovascular, renal and metabolic conditions, including obesity and diabetes.
This complex is often based on excess weight. It helps increase blood pressure and blood sugar levels. Over time, these disorders affect the condition of the kidney vessels: it becomes more difficult for the organs to filter blood and remove excess fluid. Its delay, in turn, creates additional stress on the heart and can further increase blood pressure. This creates a downward spiral in which cardiovascular, renal and metabolic disorders reinforce each other.
Doctors have long known that these conditions are related. However, the concept of SCM syndrome reflects a more modern understanding of the problem: the same factors – primarily excess weight, high blood pressure, high blood sugar and kidney failure – can contribute to the development and progression of all groups of diseases. The positive side of this approach is that in many cases similar methods can be used for their prevention and treatment.
SCM syndrome is estimated to affect about 90% of Americans precisely because it covers a wide range of conditions. This spectrum may include people who feel well but already have early metabolic risk factors, as well as patients with significant cardiovascular or renal disease.
“This does not mean that 90% of Americans need treatment. The goal is not to overmedicalize people's lives, but to increase prevention. Rather, the message is that 90% of Americans need to understand that they are at least at risk of progression of one or more conditions – metabolic, renal or cardiac – and early lifestyle changes can help,” said Muthiya Vaduganathan, a cardiologist at Brigham and Women's Hospital (Massachusetts).
According to Joshua Joseph, an endocrinologist at The Ohio State University Wexner Medical Center, many Americans are at risk due to modern lifestyles.
“We live in an environment that impacts us 24/7, and it can be difficult to eat right, be physically active and get enough sleep. In addition, approximately 20% of US adults use tobacco products, which also increases the risk,” Joseph said.
In the early stages, treatment for SCM syndrome focuses primarily on lifestyle changes. In addition to dietary changes, AHA recommendations emphasize the importance of regular physical activity, avoiding nicotine, getting enough sleep, and for overweight people, participating in supervised weight loss programs.
At later stages, today more and more attention is paid to new drugs that can act on several parts of the SCM syndrome at once. Thus, drugs of the GLP-1 class (for example, based on semaglutide) help reduce weight and blood sugar levels, including by slowing down digestion. Research also shows that they may benefit the heart and kidneys.
Another class of drugs used are SGLT2 inhibitors. They help eliminate excess sugar in the urine and, in doing so, studies have shown to reduce the risk of hospitalization due to heart failure and also help improve kidney function.
