Table 4 Incident Rates and Hazard ratios for Stage 4 Cardiovascular-Kidney-Metabolic (CKM) syndrome among Jackson Heart Study participants with Stage 2 and Stage 3 with and without hypertension.

	Number of participants	Number of participants developing incident Stage 4 CKM	Person-years of follow up	Incidence rate per 1000/person years (95% CI)	Hazard ratio (95% CI)
	Number of participants	Number of participants developing incident Stage 4 CKM	Person-years of follow up	Incidence rate per 1000/person years (95% CI)	Model 1	Model 2	Model 3
CKM Stage 2¹ (N = 1464)
No hypertension with other risk factors	298	20 (15.0%)	3291	6.0 (3.4, 8.7)	reference	reference	reference
Hypertension and other risk factors	828	94 (70.6%)	8741	10.7 (8.5, 12.9)	1.49 (0.91, 2.42)	1.54 (0.94, 2.50)	1.48 (0.90, 2.41)
Hypertension only	338	19 (14.3%)	3703	5.1 (2.8, 7.4)	0.80 (0.42, 1.49)	0.86 (0.46, 1.62)	0.86 (0.46, 1.63)
CKM Stage 3² (N = 225)
No hypertension and have other risk factors	11	1 (1.6%)	112	8.8 (−8.5, 26.2)	Not Assessed^a
Hypertension and other risk factors	183	57 (91.9%)	1493	38.1 (28.2, 48.0)
Hypertension only	31	4 (6.4%)	291	13.7 (0.2, 27.1)

Model 1: age, sex, education.
Model 2: Model 1 + smoking and alcohol use.
Model 3: Model 2 + body mass index.
1. For participants with Stage 2 CKM and with no hypertension and with other metabolic risk factors (n = 298): 206 (69%) had 1 risk factor, 62 (21%) had 2 risk factors, 27 (9%) had 3 risk factors, and 3 (1%) had 4 risk factors. For participants with Stage 2 CKM with hypertension and with other metabolic risk factors (n = 828): 377 (46%) had 2 risk factors, 281 (34%) had 3 risk factors, 151 (18%) had 4 risk factors, and 19 (2%) had all 5 risk factors.
2. For participants with Stage 3 CKM with no hypertension and with other metabolic risk factors (n = 11): 9 (82%) had 1 risk factor, 1 (9%) had 2 risk factors and 1 (9%) had 3 risk factors.
For participants with Stage 3 CKM with hypertension and with other metabolic risk factors (n = 183): 44 (24%) had 2 risk factors, 61 (33%) had 3 risk factors, 59 (32%) had 4 risk factors, and 19 (11%) had all 5 risk factors.
CKM cardiovascular-kidney-metabolic syndrome; CI confidence interval.
^aWe did not fit the Cox regression model given the small sample size and event size among participants with stage 3 CKM without hypertension and with other risk factors.

Search