What is CVRM?

Each organ of the body performs a specific task, but also depends on the other organs to function well. When one isn’t working properly, it places stress on other parts of the body, negatively affecting their functioning and jeopardising your health as a whole. An important example of this interconnection is how the heart, kidneys and pancreas affect one another, and the corresponding links between cardiovascular disease, chronic kidney disease and Type 2 diabetes.¹

This is of growing concern in medicine, as these diseases are common and shorten far too many lives unnecessarily, as these stats show:

• Cardiovascular disease is the world’s number one cause of mortality, causing nearly one third of all deaths.
• Chronic kidney disease affects over 10% of the world’s population, more than 800 million people.
• Type 2 Diabetes affects 415 million people worldwide, likely rising to half a billion by 2040.^2,3,4

The connections between the Cardiovascular, Renal and Metabolism systems and their associated diseases are so significant that they are being increasingly grouped together as “CVRM”:

CV: Cardiovascular refers to the heart and blood vessels. Conditions that affect this system are known as heart, or more correctly, cardiovascular diseases, and include heart attack, heart failure and stroke. The common mechanism behind much of cardiovascular disease is atherosclerosis, also known as the narrowing or hardening of the arteries.

R: Renal refers to the kidneys, which can be affected by chronic kidney disease (CKD). With CKD, the kidneys are not able to perform their function of filtering the blood by removing waste and toxins.

M: Metabolism refers to the pancreas, which produces enzymes and hormones, notably insulin, which help to break down food and control blood sugar levels. Type 2 diabetes is the most common condition associated with this system.^1,5,6

Owing to the intricate connections among the cardiovascular, renal and metabolism systems through mechanisms like blood circulation and hormonal regulation, these systems can significantly influence each other in either beneficial or detrimental ways. When disease occurs in one of these areas, it raises risk for disease in the other two areas:^1,6

The heart pumps blood to the body’s organs, including the pancreas and kidneys. If blood flow to these organs is impeded, as occurs, for example, with atherosclerosis, they can’t function properly.

If the kidneys are unable to filter the blood properly, blood pressure may rise, negatively affecting other organs. When the kidneys don’t work well, more stress is placed on the heart: it must pump harder for blood to reach the kidneys. This in turn can contribute to heart disease.

Insulin, produced by the pancreas, plays a key role in getting blood sugar into the cells to be used as energy. With diabetes, the pancreas either can’t make enough insulin or can’t efficiently use the insulin it does produce. Diabetes affects blood pressure and how the kidneys filter blood, and therefore also the health of the cardiovascular system.

High blood sugar can progressively damage the kidneys and lead to CKD.^1,6

Risk factors for each of the three CVRM disease areas are similar and include:¹

• High blood sugar
• High blood pressure
• Family history of CVRM diseases
• Overweight and obesity
• Unhealthy diet
• Physical inactivity.

Speak to your doctor about your risk profile for CVRM conditions.¹

The positive flip side to CVRM interconnectivity is that doctors and patients can work together to prevent and treat these conditions holistically, greatly reducing the risk of complications and further damage.⁶

You can tackle cardiovascular disease, CKD and Type 2 diabetes simultaneously by following these healthy guidelines:^1,7,8

• Check in regularly with your healthcare providers to get the treatment most appropriate for you, and guidance on how best to manage your condition and make positive lifestyle changes.
• Get moving! Choose an enjoyable physical activity, and gradually build up your fitness to at least 150 minutes’ aerobic exercise (cardio) per week, plus a couple days of strength training.
• Follow a healthy diet rich in fruit and vegetables, whole grains and lean protein, and low in processed food, added sugar and salt. This provides your body with the best fuel to function optimally and maintain a healthy weight.
• Stop smoking: it’s one of the best gifts you can give yourself.
• Get support from friends, family and the patient community. Receiving a new diagnosis and learning to live with a chronic disease can feel quite overwhelming at first, but remember, you aren’t in this alone. Many people with CVRM conditions find it very helpful to join a support group or online community and connect with others on a similar journey. These are a good place to start:
• The Heart and Stroke Foundation of South Africa https://www.heartfoundation.co.za/
• Diabetes South Africa https://www.diabetessa.org.za/
• National Kidney Foundation of South Africa (https://nkf.org.za/).