2024 Award of Meritorious Achievement winners honored for a new way of thinking about the overlapping effects of diseases

The music world's loss is the science world's gain in the case of Chiadi Ndumele and Janani Rangaswami.

Ndumele, who grew up in New Jersey, and Rangaswami, who was raised in India, are both accomplished vocalists who might have had careers in singing if they hadn't opted for medicine.

From a science standpoint, it's a good thing their musical careers are behind them, and yet they're still taking center stage. Working as a team, they've helped to establish and define cardiovascular-kidney-metabolic (CKM) syndrome, a new way of thinking about the overlapping effects of obesity, Type 2 diabetes, chronic kidney disease and cardiovascular disease.

Both longtime AHA volunteers, Ndumele and Rangaswami were lead authors on an American Heart Association 2023 presidential advisory that spelled out the stages of CKM syndrome and suggested updates to the risk calculator that helps predict a person's likelihood of having a heart attack, stroke or heart failure. Their work is expected to transform patient-centric healthcare approaches around the world.

Plus, their diplomacy and negotiation skills are top-notch, according to those who have worked closely with them. The project tested them both — and they passed with flying colors.

For their service and efforts to help people live longer, healthier lives, Ndumele and Rangaswami will be honored with the AHA's Award of Meritorious Achievement during the organization's annual National Volunteer Awards ceremony on May 2. The award is given annually to individuals or organizations that have rendered an important service to the association.

"With their innovative thinking, and ceaseless work to make the presidential advisory a reality, Chiadi and Janani are a powerful pair to elevate awareness of CKM syndrome," said Mariell Jessup, the American Heart Association's chief science and medical officer. "We especially appreciate how their work dovetails perfectly with our focus on equity for all."

Ndumele grew up singing harmony with his family, won collegiate awards for a cappella singing – vocals with no instruments – and even crooned at the White House. "I loved singing," he said, "but I always knew science was going to be my main career focus."

Rangaswami is a professionally trained singer of South Indian (Carnatic) classical music and a third-generation musician who juggled science and music careers in India. In the end, medicine won out. "It was really intense and rewarding to have simultaneous careers, but it became too difficult," she said.

One upside is that singing vastly improved her doctor-patient skills.

"Being a performer teaches you a lot about reading an audience's emotions," she said. "It gives you an empathy and heightened sensitivity that you can bring to the bedside, which is something I'm deeply grateful for."

In a sense, heightened sensitivity is at the core of cardiovascular-kidney-metabolic syndrome. Placing the patient at the center of care instead of treating each individual condition on its own offers a holistic approach in shared decision-making for clinicians and patients.

"It's hard for a patient to navigate their illness when their cardiologist might be suggesting slightly different things than their nephrologist or endocrinologist or primary care physician. For optimal CKM care, we need to be thinking about strategies from the standpoint of the patient," said Ndumele, an associate professor of medicine and director of obesity and cardiometabolic research in the division of cardiology at Johns Hopkins University in Baltimore.

As an expert in cardiovascular-kidney disease, Rangaswami knows all too well the bias of viewing diseases as separate entities. After caring for several patients with kidney disease who suffered adverse consequences from a disproportionate burden of cardiovascular disease, she learned about the concept of "renalism," a term she describes as "the systematic exclusion of patients with kidney disease from cardiovascular disease therapies or trials."

Rangaswami said the AHA is "the perfect medium to elevate awareness of CKM syndrome."

"The project brings out that multidisciplinary spirit that is part of what the AHA stands for. The AHA brings together medical professionals from so many disciplines and backgrounds to make the best science happen," said Rangaswami, chief of nephrology at the Washington DC VA Medical Center and a professor of medicine at the George Washington University School of Medicine.

Ndumele said the AHA is uniquely qualified to support a major goal behind CKM syndrome: addressing social factors, such as inadequate nutrition or a lack of places to exercise.

"CKM syndrome is a direct contributor to health disparities, and the American Heart Association's mission includes enhancing equity and helping individuals from all backgrounds. We deeply appreciate this award and the impactful, powerful science that the American Heart Association makes possible."