Study Finds Early Artery Damage in Young Adults with CKM Syndrome, Urging Earlier Prevention

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 adult participants, average age 23, had cardiovascular-kidney-metabolic syndrome (CKM syndrome). The research, released today, highlights the urgent need for cardiovascular disease prevention efforts to begin earlier in life.

The study assessed 1,283 participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, a diverse cohort. Investigators evaluated cardiovascular health using two complementary tools: CKM syndrome staging and the American Heart Association's Life's Essential 8 metrics. They also used ultrasound imaging to check for signs of arterial injury in the carotid arteries.

Results showed that nearly 80% of participants met criteria for CKM syndrome stage 1, 2, or 3, meaning they already had excess adiposity, metabolic risk factors, or evidence of subclinical cardiovascular disease. Only 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 exhibited 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 into stages 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—that provide a framework for measuring and improving cardiovascular health.

Current guidelines recommend using the PREVENT equations to estimate cardiovascular risk, but those are validated for ages 30-79. For younger adults, Lloyd-Jones suggests focusing on optimizing Life's Essential 8 metrics. “For people in their 20s, we want to focus on improving cardiovascular health,” he said, emphasizing that these measures help understand how lifestyle choices influence heart, kidney, and metabolic health over time.

The study's limitations include its cross-sectional design, which cannot establish cause and effect, and the use of some self-reported data. Additionally, because the cohort intentionally included many individuals from disadvantaged backgrounds, findings may not be generalizable to all young adults. Researchers call for long-term studies to determine how CKM syndrome stage in young adulthood relates to future cardiovascular risk.

These findings underscore the importance of early cardiovascular risk assessment and prevention strategies. By identifying at-risk individuals in their 20s, clinicians can intervene earlier, potentially preventing the progression to clinical cardiovascular disease.