The Cardiac, Renal, Diabetes and Stroke National Clinical Networks in conjunction with the Long-Term Conditions and Planning, Funding and Outcome Teams in Te Whatu Ora have developed national consensus best-practice guidance on optimising Cardiovascular-Kidney-Metabolic (CKM) health and reducing associated risk factors in adults.
The prevalence of CKM disease continues to increase and is a major cause of morbidity and mortality in Aotearoa New Zealand. Importantly, CKM disease also creates significant disparities for Māori, Pacific and Indian populations which have not improved over the past 20 years. This has provided the catalyst for Aotearoa New Zealand to develop holistic and people centric consensus guidance which aims to improve outcomes for all people with CKM disease and to eliminate current disparities and achieve equity.
The intent is to have a concise and pragmatic resource for all health professionals working with people who have CKM disease, particularly in community care. The guidance will link into appropriate specialist society detailed guidelines and Health Pathways wherever needed and possible. Our guidance will be updated as evidence and practice evolve. New sections will also be added with time including management of metabolic dysfunction-associated steatotic liver disease, obstructive sleep apnoea and more detailed guidance on interventions for weight loss.
We have included suggestions on the likely best medications to use based on efficacy, tolerance and adherence for prescribers if needed. Tips to improve access and alternatives are provided when these medications are not funded or available. As per all aspects of the guidance, all suggestions are recommendations only and clinical judgement and individualisation of care remain paramount. This link summarises the changes in the guidance from previous care.