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) stages 1-3. The study also found that those in more advanced stages had early signs of arterial injury, underscoring the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
Researchers assessed the cardiovascular health of 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort. They used two measures: CKM syndrome staging and the American Heart Association's Life's Essential 8™ cardiovascular health score. Ultrasound imaging of the carotid arteries checked for signs of arterial injury.
“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, cardiologist at Boston Medical Center, and professor at Boston University’s Chobanian & Avedisian School of Medicine.
CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease. It is categorized by stages from 0 (no risk factors) to 4 (existing cardiovascular conditions). Life's Essential 8™ measures health behaviors and factors including diet, physical activity, tobacco use, sleep, weight, cholesterol, blood sugar, and blood pressure.
The study found that nearly 80% of participants 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 risk factors (Stage 0), and none were in stage 4. Those with more advanced CKM stages had poorer Life's Essential 8 scores and thicker carotid artery walls, an early marker of atherosclerosis, even in their early 20s.
Because the PREVENT™ equations, recommended by the American Heart Association/American College of Cardiology guidelines, are validated for people aged 30-79, they are not applicable to this younger group. Lloyd-Jones recommends focusing on Life’s Essential 8 to optimize cardiovascular health. “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, because the cohort included many individuals from disadvantaged backgrounds, findings may not be generalizable to all young adults. Researchers call for additional long-term studies to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease risk.
This research has significant implications for healthcare providers and public health policy. It suggests that cardiovascular risk assessment and prevention should start in early adulthood, not middle age. For business leaders, this highlights the importance of workplace wellness programs that promote heart-healthy lifestyles among younger employees, potentially reducing long-term healthcare costs and improving productivity. As obesity rates climb, with about 40% of adults and 20% of youth affected in 2023, early intervention is critical to curb the rising burden of cardiovascular disease.
