A new scientific study published today in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, found that nearly 8 out of 10 young adults, average age 23, already have cardiovascular-kidney-metabolic (CKM) syndrome. The research, which assessed 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, revealed that those with more advanced CKM syndrome stages showed early signs of arterial injury, including thickened carotid artery walls, an early marker of atherosclerosis.
CKM syndrome describes the interconnected relationship between obesity, diabetes, chronic kidney disease, and cardiovascular disease. It is categorized into stages from 0 (no risk factors) to 4 (existing cardiovascular conditions). In this study, nearly 80% of participants met criteria for stages 1-3, meaning they already had excess adiposity, metabolic risk factors, or evidence of subclinical cardiovascular disease. None were in stage 4.
“The study shows that CKM syndrome staging and Life’s Essential 8 are complementary for identifying adults younger than age 30 who may be on the fast track for arterial injury, plaque build-up and, ultimately, at higher risk for future cardiovascular events,” said study author Donald Lloyd-Jones, M.D., M.S., an American Heart Association volunteer and cardiologist at Boston Medical Center.
Participants with more advanced CKM syndrome stages also had lower cardiovascular health scores as measured by the American Heart Association’s Life’s Essential 8™ metrics. These metrics include healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, healthy cholesterol, healthy blood sugar, and healthy blood pressure. The findings underscore the importance of measuring and monitoring cardiovascular health early in life.
Current guidelines from the American Heart Association and American College of Cardiology recommend using the PREVENT™ equations to estimate 10- and 30-year cardiovascular disease risk, but those equations are only validated for ages 30-79. For younger adults, Lloyd-Jones suggests focusing on Life’s Essential 8 to optimize health now and long-term. “For people in their 20s, we want to focus on improving cardiovascular health,” he said, emphasizing that these metrics help individuals understand how lifestyle choices affect heart, kidney, and metabolic health over time.
The study’s findings highlight the urgent need for prevention efforts to begin earlier in life, as early arterial injury can lead to plaque build-up and future cardiovascular events. “There are opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent,” the researchers concluded.
However, the study has limitations, including its cross-sectional design, which cannot establish cause and effect, and the use of self-reported data. Additionally, because the study population included many individuals from disadvantaged backgrounds, the findings may not be generalizable to all young adults. Further long-term studies are needed to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease risk.
This research, funded by the American Heart Association and other sources, adds to the growing body of evidence that cardiovascular risk begins early in life. It underscores the importance of early lifestyle interventions and regular health assessments to prevent the progression of CKM syndrome and reduce the burden of cardiovascular disease.
