A new scientific study published in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, found that nearly 8 out of 10 young adult participants, average age 23, had cardiovascular-kidney-metabolic syndrome (CKM syndrome). The research, released today, also discovered that participants with more advanced CKM syndrome stages showed early signs of arterial injury, underscoring the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
Investigators assessed cardiovascular health in 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort. They determined each participant's CKM syndrome stage and their Life's Essential 8 cardiovascular health score, then checked for arterial injury using ultrasound imaging of the carotid arteries. Nearly 80% met criteria for CKM syndrome stages 1-3, meaning they had excess adiposity, metabolic risk factors, or subclinical cardiovascular disease. About 21% had no identifiable risk factors (stage 0), and 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.
Young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores and thicker carotid artery walls, an early marker of atherosclerosis. This finding is particularly concerning because it indicates that vascular damage begins well before traditional cardiovascular disease becomes apparent.
CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease, categorized into stages from 0 (no risk factors) to 4 (existing cardiovascular conditions). The American Heart Association's Life's Essential 8 framework measures health behaviors and factors to monitor and improve cardiovascular health, including diet, physical activity, tobacco avoidance, sleep, weight, cholesterol, blood sugar, and blood pressure.
Current guidelines recommend using the PREVENT™ equations to estimate cardiovascular risk, but these are validated only for adults aged 30-79. For younger adults, Lloyd-Jones suggests focusing on optimizing Life's Essential 8 metrics. “For people in their 20s, we want to focus on improving cardiovascular health,” he said, noting that the framework is designed for measuring, monitoring, and improving cardiovascular health at any age, especially in adolescents and young adults.
The study's limitations include its cross-sectional design, which cannot establish cause and effect, and the use of some self-reported data. Additionally, the cohort included many individuals from disadvantaged backgrounds, so findings may not generalize to all young adults. Researchers call for long-term studies to determine how CKM syndrome stage in young adulthood relates to future cardiovascular risk.
“The findings highlight the urgent need for prevention efforts to begin earlier in life,” the authors concluded, suggesting there are opportunities to improve cardiovascular health and prevent disease progression long before it becomes clinically apparent. This research reinforces the importance of early risk assessment and lifestyle interventions in young adults to curb the rising burden of cardiovascular disease.
