Late-Stage Concentration of Cardiovascular-Kidney-Metabolic Syndrome Burden in US Adults: Disability-Adjusted Life Years Across AHA Stages, 2005 to 2023

Background: Cardiovascular prevention is increasingly prioritised using burden estimates, yet disability-adjusted life years (DALYs) reward late-stage treatment by construction. Whether that bias is large for cardiovascular-kidney-metabolic (CKM) syndrome, and where the population is accumulating relative to where the burden sits, is unknown. Methods: We pooled nine National Health and Nutrition Examination Survey cycles (2005-2023) and assigned CKM stages 0-4 from measured blood pressure, adiposity, glycaemia, lipids, kidney function, urine albumin, self-reported cardiovascular disease, and 1

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