A new 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 adult participants, average age 23 years, had cardiovascular-kidney-metabolic syndrome (CKM syndrome). The research also revealed that those with more advanced CKM syndrome stages had early signs of arterial injury, underscoring the need for cardiovascular disease prevention to begin earlier in life.
The study assessed participants' cardiovascular health using two methods: determining their CKM syndrome stage and their Life's Essential 8 cardiovascular health score. Ultrasound imaging of the carotid arteries was used to check for signs of arterial injury. The findings showed that participants with higher 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, and is categorized into stages from 0 (no risk factors) to 4 (existing cardiovascular conditions). The American Heart Association's Life's Essential 8 metrics include healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, healthy cholesterol, healthy blood sugar, and healthy blood pressure.
Current guidelines recommend using the PREVENT™ equations to estimate cardiovascular disease risk, but those equations are validated only for people aged 30-79 years. Because of the young age of participants in this study, the PREVENT equations were not applicable. Lloyd-Jones emphasized that for people in their 20s, the focus should be on improving cardiovascular health using Life's Essential 8, which is designed for measuring, monitoring, and improving cardiovascular health at any age.
The study analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort with an average age of 23 years. Nearly 80% met criteria for CKM syndrome stage 1, 2, or 3, meaning they already had excess adiposity, metabolic risk factors, or evidence of subclinical cardiovascular disease. About 21% had no identifiable CKM risk factors (Stage 0), and none were in stage 4.
Researchers concluded that these findings highlight the urgent need for prevention efforts to begin earlier in life, suggesting opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent. The study has limitations, including its cross-sectional design and the use of some self-reported data, and the findings may not be generalizable to all young adults. Additional long-term studies are needed to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease risk.
For more information on CKM syndrome and cardiovascular health, the American Heart Association provides resources on heart.org. The full manuscript is available online.
