A new study published in Circulation: Population Health and Outcomes has found that nearly 8 out of 10 young adult participants, with an average age of 23 years, had cardiovascular-kidney-metabolic syndrome (CKM syndrome) stages 1 to 3. The research, conducted by investigators from the American Heart Association, also 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, which analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, highlights the urgent need for cardiovascular disease prevention efforts to begin earlier in life. The participants were assessed using both the CKM syndrome staging system and the American Heart Association's Life's Essential 8™ metrics, which measure health behaviors and health factors such as diet, physical activity, sleep, and blood pressure.
According to the study, approximately 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 CKM risk factors (stage 0), and none were in stage 4. The researchers found that young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores and more evidence of arterial injury.
“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. Lloyd-Jones, who is also a cardiologist at Boston Medical Center and professor of medicine at Boston University’s Chobanian & Avedisian School of Medicine, emphasized that these findings are crucial for early prevention.
Because the study participants were so young, the PREVENT™ equations, which are typically used to estimate 10- and 30-year cardiovascular risk in adults aged 30-79, are not applicable. Instead, Lloyd-Jones recommends that clinicians focus on Life’s Essential 8 metrics to help young adults improve their cardiovascular health. “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’s findings are particularly concerning given the rising rates of obesity and metabolic risk factors among young people. The researchers concluded that there are opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent. However, they also noted limitations, including the cross-sectional design, which cannot establish cause and effect, and the fact that the study population intentionally included many individuals from disadvantaged backgrounds, which may limit generalizability.
The study underscores the importance of early cardiovascular risk assessment and the need for public health strategies that target young adults. As Lloyd-Jones noted, “The conversation should focus on Life’s Essential 8 and optimizing as many of those metrics as possible for better health today and long term.” By addressing risk factors early, it may be possible to reduce the burden of cardiovascular disease in later life.
