A new scientific study published in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, reveals that nearly 8 out of 10 young adults, with an average age of 23, already have cardiovascular-kidney-metabolic (CKM) syndrome stages 1-3. The research, which assessed 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, found that those in higher CKM stages showed early signs of 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, cardiologist at Boston Medical Center, and professor of medicine at Boston University’s Chobanian & Avedisian School of Medicine.
CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease, and is categorized by stages ranging from 0 (no risk factors) to 4 (existing cardiovascular conditions). The study found that nearly 80% of participants met criteria for CKM syndrome stage 1, 2, or 3, meaning they had excess adiposity, metabolic risk factors, or subclinical cardiovascular disease. About 21% had no identifiable risk factors (Stage 0), and none were in stage 4.
Participants with more advanced CKM stages also had poorer scores on the American Heart Association’s Life’s Essential 8 metrics, which include healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, healthy cholesterol, healthy blood sugar, and healthy blood pressure. These metrics are designed to measure, monitor, and improve cardiovascular health at any age, but especially in adolescents and young adults.
The findings highlight the urgent need for cardiovascular disease prevention efforts to begin earlier in life. "For people in their 20s, we want to focus on improving cardiovascular health," Lloyd-Jones said, emphasizing that the Life’s Essential 8 framework helps people understand how lifestyle choices influence heart, kidney, and metabolic health over time and provides practical steps to improve overall health.
The study also noted that current guidelines recommend using the PREVENT™ equations to estimate 10- and 30-year cardiovascular risk, but those equations were developed for people aged 30-79. Since participants in this study were younger, the PREVENT equations are not applicable. Lloyd-Jones recommends that conversations with young adults focus on optimizing Life’s Essential 8 metrics for better health today and long term.
Researchers concluded that the findings suggest opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent. However, the study has limitations, including its cross-sectional design, which cannot establish cause and effect, and the use of some self-reported health behavior data. Additionally, because the study population intentionally included many individuals from disadvantaged backgrounds, the findings may not be generalizable to all young adults.
This research underscores the importance of early cardiovascular risk assessment and intervention, even in young adulthood, to prevent the development of cardiovascular disease later in life. The American Heart Association has been a leading source of health information for more than one hundred years and continues to fund research and provide resources to improve cardiovascular health.
