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 adults, with an average age of 23, have cardiovascular-kidney-metabolic syndrome (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, also found that those with more advanced CKM syndrome had early signs of arterial injury, highlighting the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
Investigators evaluated participants' cardiovascular health using two complementary tools: CKM syndrome staging and the American Heart Association's Life's Essential 8™ metrics. CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease, with stages ranging from 0 (no risk factors) to 4 (existing cardiovascular conditions). Life's Essential 8 comprises health behaviors and health factors, including diet, physical activity, tobacco exposure, sleep, weight, cholesterol, blood sugar, and blood pressure.
The study revealed that participants in higher CKM syndrome stages had poorer Life's Essential 8 scores and showed early markers of atherosclerosis, such as thicker carotid artery walls, even in their early 20s. "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 lead author Donald Lloyd-Jones, M.D., M.S., a cardiologist at Boston Medical Center and professor at Boston University's Chobanian & Avedisian School of Medicine.
Because current risk prediction equations like PREVENT are validated for adults aged 30-79, they are not applicable to this younger cohort. Lloyd-Jones recommends that clinicians focus conversations with young adults on optimizing Life's Essential 8 metrics to improve health now and long-term. "For people in their 20s, we want to focus on improving cardiovascular health," he said, emphasizing that these everyday measures help individuals understand how lifestyle choices influence heart, kidney, and metabolic health over time.
The findings underscore the need for early prevention efforts, as subclinical cardiovascular disease may begin decades before clinical events. The study's limitations include its cross-sectional design, which cannot establish causality, and the use of self-reported data. The researchers call for additional long-term studies to determine how CKM syndrome stage in young adulthood relates to future cardiovascular risk.
For more information on CKM syndrome and cardiovascular health, visit the American Heart Association's metabolic syndrome page and learn about Life's Essential 8. The study was published in Circulation: Population Health and Outcomes.
