A new scientific study reveals that nearly 8 out of 10 young adults with an average age of 23 show early signs of cardiovascular-kidney-metabolic syndrome. Published in Circulation: Population Health and Outcomes, the findings demonstrate that advanced stages of this interconnected condition are linked to early arterial injury.
Cardiovascular disease prevention efforts may need to start much earlier in life. According to independent research published in the peer-reviewed scientific journal Circulation: Population Health and Outcomes, researchers found that nearly 8 out of 10 young adult participants, with an average age of 23 years, exhibited cardiovascular-kidney-metabolic syndrome, commonly referred to as CKM syndrome.
The study analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study. Investigators evaluated participants using two primary metrics: CKM syndrome staging and the American Heart Association’s Life’s Essential 8 cardiovascular health score.
Uncovering Subclinical Disease and Arterial Injury in Early Adulthood
Scientists discovered that approximately 80% of participants met the criteria for CKM syndrome stage 1, 2, or 3. These stages indicate that young adults already possess excess adiposity, metabolic risk factors, and/or evidence of subclinical cardiovascular disease. Meanwhile, about 21% of participants had no identifiable CKM risk factors and fell into Stage 0, while none of the participants reached stage 4.
More advanced CKM syndrome stages were associated with early signs of arterial injury. Researchers checked for these physical changes using ultrasound imaging of the carotid arteries, which are the large blood vessels in the neck carrying blood to the brain. The findings showed that advanced CKM stages correlated with thicker carotid artery walls—an early marker of atherosclerosis—even among individuals in their early 20s.
Donald Lloyd-Jones M.D., M.S., cardiologist at Boston Medical Center, professor of medicine at Boston University’s Chobanian & Avedisian School of Medicine, director of the Framingham Center for Population and Prevention Science, and principal investigator of the Framingham Heart Study stated that the study shows 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.
Understanding the Interconnected Nature of CKM Syndrome
CKM syndrome describes the interconnected relationship connecting obesity, diabetes, chronic kidney disease, and cardiovascular disease. The syndrome spans stages from 0, representing no risk factors, up to 4, which involves existing cardiovascular conditions like coronary heart disease, heart failure, or stroke.
In parallel, the American Heart Association’s Life’s Essential 8 framework provides metrics across health behaviors and health factors to measure, monitor, and improve cardiovascular health. The framework encompasses healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, healthy cholesterol, healthy blood sugar, and healthy blood pressure. Study results showed that young adults with more advanced CKM syndrome stages also possessed poorer Life’s Essential 8 scores.
Clinical Challenges and the Shift Toward Prevention
American Heart Association and American College of Cardiology guidelines recommend using the Predicting Risk of cardiovascular disease EVENTs (PREVENT) equations to estimate 10- and 30-year risks for high blood pressure, high cholesterol, and CKM syndrome. However, because those equations were developed and validated for individuals ages 30 to 79, they are not applicable to patients in their early 20s.
Donald Lloyd-Jones M.D., M.S., American Heart Association volunteer and former volunteer president suggested that for people in their 20s, the focus should be on improving cardiovascular health, recommending that conversations focus on Life’s Essential 8 and optimizing as many of those metrics as possible for better health today and in the long term.
Lloyd-Jones explained that everyday health measures help people understand how lifestyle choices shape heart, kidney, and metabolic health over time, offering practical steps to improve overall well-being.
Study Limitations and Future Research Directions
While the findings point toward an urgent need for early prevention, researchers noted several limitations within the study.
