A new scientific study published in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, has found that nearly 8 out of 10 young adults, with an average age of 23, already have early signs of cardiovascular-kidney-metabolic (CKM) syndrome. The research highlights the urgent need for cardiovascular disease prevention efforts to begin earlier in life, as participants with more advanced CKM syndrome stages showed early signs of arterial injury.
The study assessed cardiovascular health in 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort. Investigators used two methods to evaluate cardiovascular health: determining the CKM syndrome stage and the American Heart Association's Life's Essential 8 cardiovascular health score. They also used ultrasound imaging to check for signs of arterial injury in the carotid arteries.
Nearly 80% of participants met criteria for CKM syndrome stage 1, 2, or 3, indicating they already had excess adiposity, metabolic risk factors, or subclinical cardiovascular disease. Only about 21% had no identifiable CKM risk factors (stage 0), and none were in stage 4. The study found that young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores and evidence of early arterial injury, including 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. It is categorized into stages from 0 (no risk factors) to 4 (existing cardiovascular conditions). Life's Essential 8 comprises two major areas: health behaviors (diet, physical activity, tobacco use, sleep) and health factors (weight, cholesterol, blood sugar, blood pressure).
Current guidelines recommend using the PREVENT™ equations to estimate cardiovascular risk in people aged 30-79. However, because the study participants were younger, those equations are not applicable. Lloyd-Jones recommends focusing on Life's Essential 8 to optimize health metrics for better health today and long-term.
“For people in their 20s, we want to focus on improving cardiovascular health,” Lloyd-Jones said. He emphasized that the Life's Essential 8 framework is designed for measuring, monitoring, and improving cardiovascular health at any age, especially in adolescents and young adults.
The study has limitations, including its cross-sectional design, which shows association but cannot establish cause and effect, and the use of some self-reported health behavior data. Because the study population intentionally included many individuals from disadvantaged backgrounds, 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.
The findings underscore the importance of early cardiovascular risk assessment and prevention. As Lloyd-Jones noted, these everyday health measures help people understand how lifestyle choices influence heart, kidney, and metabolic health over time and provide practical steps to improve overall health. The study was published in the American Heart Association's journal and is part of ongoing efforts to address cardiovascular health across the lifespan.
