{"id":"https://openalex.org/W7225464756","doi":"https://doi.org/10.64898/2026.11.05.26367395","title":"Late-Stage Concentration of Cardiovascular-Kidney-Metabolic Syndrome Burden in US Adults: Disability-Adjusted Life Years Across AHA Stages, 2005 to 2023","display_name":"Late-Stage Concentration of Cardiovascular-Kidney-Metabolic Syndrome Burden in US Adults: Disability-Adjusted Life Years Across AHA Stages, 2005 to 2023","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225464756","doi":"https://doi.org/10.64898/2026.11.05.26367395"},"language":"en","primary_location":{"id":"doi:10.64898/2026.11.05.26367395","doi":"https://doi.org/10.64898/2026.11.05.26367395","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367395","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367395.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367395.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5107920586","display_name":"Xia Wang","orcid":"https://orcid.org/0009-0009-8470-0533","observed_orcids":["https://orcid.org/0009-0009-8470-0533"]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaolei Wang","raw_affiliation_strings":["Beijing University of Chinese Medicine Dongfang Hospital, CHINA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing University of Chinese Medicine Dongfang Hospital, CHINA;","institution_ids":["https://openalex.org/I17747738"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071881537","display_name":"Yu Qiao","orcid":"https://orcid.org/0000-0003-4670-724X","observed_orcids":["https://orcid.org/0000-0003-4670-724X"]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yu Qiao","raw_affiliation_strings":["Beijing University of Chinese Medicine Dongfang Hospital, CHINA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing University of Chinese Medicine Dongfang Hospital, CHINA;","institution_ids":["https://openalex.org/I17747738"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161193454","display_name":"Hongfeng Sun","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hongfeng Sun","raw_affiliation_strings":["Beijing University of Chinese Medicine Dongfang Hospital, CHINA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing University of Chinese Medicine Dongfang Hospital, CHINA;","institution_ids":["https://openalex.org/I17747738"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161230086","display_name":"Ying Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ying Wang","raw_affiliation_strings":["Beijing University of Chinese Medicine Dongfang Hospital, CHINA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing University of Chinese Medicine Dongfang Hospital, CHINA;","institution_ids":["https://openalex.org/I17747738"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159560077","display_name":"Hui Zhou","orcid":"https://orcid.org/0009-0001-8945-6439","observed_orcids":["https://orcid.org/0009-0001-8945-6439"]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Hui Zhou","raw_affiliation_strings":["Beijing University of Chinese Medicine Dongfang Hospital, CHINA;"],"raw_orcid":"https://orcid.org/0009-0001-8945-6439","affiliations":[{"raw_affiliation_string":"Beijing University of Chinese Medicine Dongfang Hospital, CHINA;","institution_ids":["https://openalex.org/I17747738"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161161053","display_name":"Taojing Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I17747738","display_name":"Beijing University of Chinese Medicine","ror":"https://ror.org/05damtm70","country_code":"CN","type":"education","lineage":["https://openalex.org/I17747738"]},{"id":"https://openalex.org/I4210121586","display_name":"Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine","ror":"https://ror.org/02yacz525","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121586"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Taojing Zhang","raw_affiliation_strings":["Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, CHINA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, CHINA","institution_ids":["https://openalex.org/I17747738","https://openalex.org/I4210121586"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5159560077"],"corresponding_institution_ids":["https://openalex.org/I17747738"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10027","display_name":"Diabetes, Cardiovascular Risks, and Lipoproteins","score":0.6840999722480774,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10027","display_name":"Diabetes, Cardiovascular Risks, and Lipoproteins","score":0.6840999722480774,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13522","display_name":"Cardiovascular Health and Risk Factors","score":0.14830000698566437,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12935","display_name":"Healthcare Systems and Public Health","score":0.03620000183582306,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cardiovascular-kidney-metabolic-syndrome","display_name":"cardiovascular-kidney-metabolic syndrome","score":0.9959999918937683},{"id":"https://openalex.org/keywords/disability-adjusted-life-years","display_name":"disability-adjusted life years","score":0.8859999775886536},{"id":"https://openalex.org/keywords/disease-burden","display_name":"disease burden","score":0.7070000171661377},{"id":"https://openalex.org/keywords/disease-staging","display_name":"disease staging","score":0.5630000233650208},{"id":"https://openalex.org/keywords/late-stage-disease","display_name":"late-stage disease","score":0.6209999918937683},{"id":"https://openalex.org/keywords/cardiovascular-disease","display_name":"cardiovascular disease","score":0.4259999990463257},{"id":"https://openalex.org/keywords/chronic-kidney-disease","display_name":"chronic kidney disease","score":0.7599999904632568},{"id":"https://openalex.org/keywords/metabolic-syndrome","display_name":"metabolic syndrome","score":0.6420000195503235},{"id":"https://openalex.org/keywords/years-of-life-lost","display_name":"years of life lost","score":0.7799999713897705},{"id":"https://openalex.org/keywords/years-lived-with-disability","display_name":"years lived with disability","score":0.9490000009536743},{"id":"https://openalex.org/keywords/smoking","display_name":"smoking","score":0.6439999938011169},{"id":"https://openalex.org/keywords/physical-inactivity","display_name":"physical inactivity","score":1.0},{"id":"https://openalex.org/keywords/cardiovascular-disease-prevention","display_name":"cardiovascular disease prevention","score":0.5730000138282776},{"id":"https://openalex.org/keywords/prevalence-trends","display_name":"prevalence trends","score":0.5260000228881836},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.4699999988079071},{"id":"https://openalex.org/keywords/nhanes","display_name":"NHANES","score":0.7009999752044678},{"id":"https://openalex.org/keywords/united-states-adults","display_name":"United States adults","score":0.6259999871253967}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8162999749183655},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.5892000198364258},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.4896000027656555},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.4875999987125397},{"id":"https://openalex.org/C126451531","wikidata":"https://www.wikidata.org/wiki/Q2852035","display_name":"Years of potential life lost","level":4,"score":0.3952000141143799},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.3874000012874603},{"id":"https://openalex.org/C2779874844","wikidata":"https://www.wikidata.org/wiki/Q1967281","display_name":"National Health and Nutrition Examination Survey","level":3,"score":0.3671000003814697},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3603000044822693},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3529999852180481},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.3513000011444092},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.33169999718666077},{"id":"https://openalex.org/C2779951463","wikidata":"https://www.wikidata.org/wiki/Q7268788","display_name":"Quality of life (healthcare)","level":2,"score":0.32330000400543213},{"id":"https://openalex.org/C133925201","wikidata":"https://www.wikidata.org/wiki/Q188419","display_name":"Life expectancy","level":3,"score":0.2903999984264374},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.28760001063346863},{"id":"https://openalex.org/C3020448403","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Burden of disease","level":3,"score":0.2865999937057495},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.26829999685287476},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.2680000066757202},{"id":"https://openalex.org/C29374701","wikidata":"https://www.wikidata.org/wiki/Q1931388","display_name":"Cause of death","level":3,"score":0.2563000023365021},{"id":"https://openalex.org/C3018122547","wikidata":"https://www.wikidata.org/wiki/Q5690813","display_name":"Health benefits","level":2,"score":0.2524999976158142},{"id":"https://openalex.org/C3020255362","wikidata":"https://www.wikidata.org/wiki/Q747883","display_name":"Physical activity","level":2,"score":0.25040000677108765}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.11.05.26367395","doi":"https://doi.org/10.64898/2026.11.05.26367395","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367395","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367395.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.11.05.26367395","doi":"https://doi.org/10.64898/2026.11.05.26367395","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367395","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367395.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225464756.pdf","grobid_xml":"https://content.openalex.org/works/W7225464756.grobid-xml"},"referenced_works_count":1,"referenced_works":["https://openalex.org/W7223366899"],"related_works":["https://openalex.org/W7134137027","https://openalex.org/W7213668080","https://openalex.org/W4411171520","https://openalex.org/W7223366899","https://openalex.org/W4411871263","https://openalex.org/W4416505972","https://openalex.org/W7162787684","https://openalex.org/W4409036859","https://openalex.org/W4413384157","https://openalex.org/W7164536955"],"abstract_inverted_index":{"Background:":[0],"Cardiovascular":[1],"prevention":[2],"is":[3,22,32,40,245,265,282],"increasingly":[4],"prioritised":[5],"using":[6],"burden":[7,38,108,238,244],"estimates,":[8],"yet":[9],"disability-adjusted":[10],"life":[11,87,102],"years":[12],"(DALYs)":[13],"reward":[14],"late-stage":[15],"treatment":[16],"by":[17],"construction.":[18],"Whether":[19],"that":[20],"bias":[21],"large":[23],"for":[24,144,235],"cardiovascular-kidney-metabolic":[25],"(CKM)":[26],"syndrome,":[27],"and":[28,48,54,73,100,111,138,159,181,214,223,231],"where":[29,36,250,263],"the":[30,37,117,255,273,277],"population":[31,256],"accumulating":[33],"relative":[34],"to":[35,109],"sits,":[39],"unknown.":[41],"Methods:":[42],"We":[43],"pooled":[44],"nine":[45],"National":[46],"Health":[47],"Nutrition":[49],"Examination":[50],"Survey":[51],"cycles":[52],"(2005-2023)":[53],"assigned":[55],"CKM":[56,118,142,243],"stages":[57,248],"0-4":[58],"from":[59,95,189,205],"measured":[60],"blood":[61],"pressure,":[62],"adiposity,":[63],"glycaemia,":[64],"lipids,":[65],"kidney":[66],"function,":[67],"urine":[68],"albumin,":[69],"self-reported":[70],"cardiovascular":[71],"disease,":[72],"10-year":[74],"PREVENT":[75],"risk.":[76],"Years":[77,85],"lived":[78],"with":[79],"disability":[80,83],"used":[81],"GBD":[82],"weights.":[84],"of":[86,124,153,167,171,179,183,237,280],"lost":[88],"combined":[89],"national":[90],"death":[91],"counts,":[92],"stage-specific":[93],"mortality":[94,97,187,252,264],"linked":[96],"files":[98],"(1999-2018),":[99],"period":[101],"tables.":[103],"A":[104],"second":[105],"aim":[106],"attributed":[107],"smoking":[110],"physical":[112,232],"inactivity,":[113],"two":[114],"exposures":[115],"outside":[116],"definition.":[119],"Results:":[120],"In":[121],"2021-2023,":[122],"13.8%":[123],"adults":[125],"were":[126,157],"stage":[127,130,133,136,140,174,190,196,200,206,216,224,261,274],"0,":[128],"21.3%":[129],"1,":[131,262],"49.1%":[132],"2,":[134],"6.5%":[135],"3,":[137],"9.3%":[139],"4.":[141],"accounted":[143,234],"20.0":[145],"million":[146,156,161],"DALYs":[147],"annually":[148],"(7,881":[149],"age-standardised":[150],"per":[151,221,228],"100,000),":[152],"which":[154,276],"4.1":[155],"YLD":[158,180],"15.9":[160],"attributable":[162,172,184],"YLL.":[163,185],"Stages":[164],"3-4,":[165,249],"15.8%":[166],"adults,":[168],"generated":[169,177],"76%":[170],"YLL;":[173],"4":[175,197],"alone":[176],"65%":[178],"49%":[182],"Adjusted":[186],"rose":[188,226],"2":[191],"(hazard":[192],"ratio":[193],"1.39)":[194],"through":[195],"(3.22),":[198],"while":[199,254],"1":[201,225],"did":[202],"not":[203],"differ":[204],"0":[207,217],"(0.99;":[208],"95%":[209],"CI,":[210,240],"0.78-1.25).":[211],"Between":[212],"2006":[213],"2016,":[215],"prevalence":[218],"fell":[219],"2.3%":[220],"year":[222],"3.1%":[227],"year.":[229],"Smoking":[230],"inactivity":[233],"30.5%":[236],"(95%":[239],"25.7-35.1).":[241],"Conclusions:":[242],"concentrated":[246],"in":[247,275],"excess":[251],"begins,":[253],"has":[257],"been":[258],"shifting":[259],"into":[260],"normal.":[266],"DALY-based":[267],"prioritisation":[268],"will":[269],"therefore":[270],"systematically":[271],"underfund":[272],"next":[278],"generation":[279],"patients":[281],"being":[283],"created.":[284]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-08T00:00:00"}
