Interrelationships Between Key Cardiovascular Risk Factors, Chronic Kidney Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease.

PURPOSE OF REVIEW: Five modifiable risk factors (RFs) - systolic blood pressure (SBP), body mass index (BMI), diabetes, non-high-density lipoprotein cholesterol (non-HDL-C), and smoking - were proposed as major determinants of the global burden of cardiovascular disease (CVD). This narrative review considers the interconnections among these RFs and their combined influence on disease development, progression, and longevity. We also consider the relationship between these factors and chronic kidney disease (CKD) and metabolic dysfunction-associated steatotic liver disease (MASLD). RECENT FINDINGS: Over the past three decades, the global prevalence and burden of CVD, CKD, and MASLD has risen substantially. These chronic conditions are leading causes of reduced life expectancy and increased disability-adjusted life years (DALYs). They share common underlying mechanisms, particularly insulin resistance and chronic inflammation, and frequently coexist, with each condition accelerating the progression and complications of the others. Evidence from studies and meta-analyses demonstrates that the five traditional RFs significantly contribute to disease onset and progression, while effective risk-factor management can delay disease progression and improve both quality of life and survival. Lifestyle interventions and emerging pharmacological therapies can favorably modify these RFs and reduce the overall burden of CVD, CKD, and MASLD. An integrated approach to managing metabolic dysfunction is essential, although it remains challenging, as improvement in one condition may adversely affect another. RFs should not just be considered individually.