Prevalence and characteristics of adults with atherosclerotic cardiovascular disease, chronic kidney disease, and systemic inflammation in the USA

Study objective: Systemic inflammation increases the risk of cardiovascular events and is often present in patients with atherosclerotic cardiovascular disease (ASCVD), particularly in those who also have chronic kidney disease (CKD). However, the prevalence of systemic inflammation in patients with ASCVD and CKD is not well characterized. Here, we estimate the prevalence of ASCVD with CKD and systemic inflammation in the US population and describe the characteristics of people with ASCVD, CKD stages 3–4, and systemic inflammation, who are at high risk for cardiorenal events. Design and setting: Cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2015–2020 continuous cycles. Participants: Adults aged ≥ 20 years with ASCVD who had high-sensitivity C-reactive protein (hsCRP) measurements. Main outcome measures: Prevalence and characteristics of adults with systemic inflammation in groups with ASCVD, with ASCVD and CKD, and with ASCVD and CKD stages 3–4. Systemic inflammation was defined as hsCRP levels ≥ 2 mg/L. Results: Our study sample included 238,164,067 adults. In total, 8.5% had ASCVD, of whom 55.5% had systemic inflammation. The prevalence of systemic inflammation in individuals with ASCVD and CKD stages 3–4 (1.6% of the US population) was 59.1%, equating to 0.9% or > 2 million individuals in the general US adult population. Conclusions: In summary, over half of US adults with ASCVD and CKD stages 3–4 were estimated to have systemic inflammation. This group could benefit from weight loss strategies, lifestyle changes, and other approaches to improve cardiovascular outcomes.