A new scientific study published today in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, reveals that nearly 8 out of 10 young adult participants, with an average age of 23, already show signs of cardiovascular-kidney-metabolic (CKM) syndrome. The research found that those with more advanced CKM syndrome stages had early signs of arterial injury, highlighting the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
The study assessed the cardiovascular health of 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort. Participants were evaluated using both the CKM syndrome staging system and the American Heart Association's Life's Essential 8 metrics. Ultrasound imaging of the carotid arteries was used to detect early arterial damage.
Results showed that nearly 80% of participants met criteria for CKM syndrome stages 1, 2, or 3, meaning they already had excess adiposity, metabolic risk factors, or evidence of subclinical cardiovascular disease. Only about 21% had no identifiable risk factors (stage 0). None were in stage 4. 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.
“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.
CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease. The Life's Essential 8 framework includes health behaviors (diet, physical activity, tobacco use, sleep) and health factors (weight, cholesterol, blood sugar, blood pressure) that are crucial for maintaining cardiovascular health.
Because current risk prediction tools like the PREVENT equations are only validated for adults aged 30-79, the study emphasizes the importance of focusing on Life's Essential 8 in younger adults. “For people in their 20s, we want to focus on improving cardiovascular health,” Lloyd-Jones said. He added that these measures help individuals understand how lifestyle choices influence heart, kidney, and metabolic health over time.
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 study population included many individuals from disadvantaged backgrounds, so findings may not be generalizable to all young adults. Researchers call for long-term studies to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease risk.
These findings underscore the critical need for early prevention and intervention. By identifying and addressing risk factors in young adulthood, it may be possible to slow or prevent the progression to clinical cardiovascular disease. The American Heart Association continues to advocate for cardiovascular health across the lifespan, with resources available at heart.org.
