A new scientific study published today in Circulation: Population Health and Outcomes, a peer-reviewed journal of the American Heart Association, found that nearly 8 out of 10 young adult participants, average age 23 years, had cardiovascular-kidney-metabolic syndrome (CKM syndrome). The research highlights the urgent need for cardiovascular disease prevention efforts to begin earlier in life.
Investigators assessed participants' cardiovascular health status using two methods: determining their CKM syndrome stage and their Life's Essential 8 cardiovascular health score. They also checked for signs of arterial injury with ultrasound imaging of the carotid arteries. The study found that participants with more advanced CKM syndrome stages had 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 and cardiologist at Boston Medical Center.
CKM syndrome describes the interconnected relationship among obesity, diabetes, chronic kidney disease, and cardiovascular disease. It is categorized by stages that reflect a person's risk factors, ranging from 0 (no risk factors) to 4 (existing cardiovascular conditions). The American Heart Association's Life's Essential 8 framework comprises health behaviors and health factors that are crucial for measuring, monitoring, and improving cardiovascular health.
Because the PREVENT equations, which estimate 10- and 30-year cardiovascular risk, are validated only for ages 30-79, they are not applicable to this younger cohort. Lloyd-Jones recommends that conversations with young adults focus on optimizing Life's Essential 8 metrics. “For people in their 20s, we want to focus on improving cardiovascular health,” he said. The Life's Essential 8 framework is designed for measuring, monitoring, and improving cardiovascular health at any age, but especially in adolescents and young adults.
The study analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study. Nearly 80% met criteria for CKM syndrome stages 1-3, meaning they already had excess adiposity, metabolic risk factors, or evidence of subclinical cardiovascular disease. About 21% had no identifiable CKM risk factors, and none were in stage 4. Young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores and early arterial injury.
“The findings highlight the urgent need for prevention efforts to begin earlier in life,” Lloyd-Jones noted. “There are opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent.”
The study has limitations, including its cross-sectional design, which shows association but not causation, and the use of some self-reported data. Additionally, because the study population included many individuals from disadvantaged backgrounds, findings may not be generalizable to all young adults. Further long-term studies are needed to determine how CKM syndrome stage in young adulthood relates to future cardiovascular disease 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.
