A new scientific study published today in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, reveals that nearly 8 out of 10 young adult participants, average age 23, already have cardiovascular-kidney-metabolic (CKM) syndrome stages 1-3. The research found that those in more advanced stages exhibit early signs of arterial injury, underscoring the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
Investigators assessed participants' cardiovascular health using both CKM syndrome staging and the American Heart Association's Life's Essential 8 metrics. They used ultrasound imaging to check for signs of arterial injury in the carotid arteries. The study included 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort with an average age of 23. The results showed that nearly 80% met criteria for CKM syndrome stage 1, 2, or 3, meaning they 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.
Young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores and thicker carotid artery walls, an early marker of atherosclerosis. The study's lead author, Donald Lloyd-Jones, M.D., M.S., an American Heart Association volunteer and cardiologist at Boston Medical Center, noted that CKM syndrome staging and Life's Essential 8 are complementary in identifying adults under 30 who may be on a fast track for arterial injury and future cardiovascular events.
Because current risk prediction equations like PREVENT are validated for people aged 30-79, they are not applicable to this younger population. Lloyd-Jones recommends focusing on Life's Essential 8 metrics—healthy eating, physical activity, avoiding tobacco, healthy sleep, healthy weight, healthy cholesterol, healthy blood sugar, and healthy blood pressure—to improve health today and long-term. These measures help people understand how lifestyle choices influence heart, kidney, and metabolic health over time.
The study highlights the importance of early cardiovascular risk assessment and prevention. Lloyd-Jones emphasized that for people in their 20s, the goal is to optimize cardiovascular health. The findings suggest there are opportunities to improve health and prevent disease progression long before cardiovascular disease becomes clinically apparent.
Limitations include the cross-sectional design, which cannot establish cause and effect, and the use of some self-reported data. The study population intentionally included many individuals from disadvantaged backgrounds, so findings may not be generalizable to all young adults. Long-term studies are needed to determine how CKM syndrome stage in young adulthood relates to future cardiovascular risk.
For more information, visit the American Heart Association's resources on metabolic syndrome and Life's Essential 8.
