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, already 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 stages had early signs of arterial injury, such as thicker carotid artery walls, which are an early marker of atherosclerosis.
The study highlights the urgent need for cardiovascular disease prevention efforts to begin earlier in life. "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). The American Heart Association's Life's Essential 8™ framework comprises two major areas: health behaviors and health factors, providing a way to measure, monitor, and improve cardiovascular health.
According to the American Heart Association and American College of Cardiology guidelines, clinicians are recommended to use the PREVENT™ equations to estimate 10- and 30-year cardiovascular disease risk. However, these equations are validated for people aged 30-79, so they are not applicable to the young adults in this study. Lloyd-Jones recommends that for people in their 20s, the focus should be 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.
"For people in their 20s, we want to focus on improving cardiovascular health," Lloyd-Jones said. He explained that 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, and has been linked to their health now and in the long-term.
The study found 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. About 21% had no identifiable CKM risk factors (Stage 0). None were in stage 4. Young adults with more advanced CKM syndrome stages had poorer Life's Essential 8 scores, and more advanced stages were associated with early arterial injury.
"The findings highlight the urgent need for prevention efforts to begin earlier in life, suggesting there are opportunities to improve cardiovascular health and prevent disease progression long before cardiovascular disease becomes clinically apparent," the researchers concluded.
The study has limitations, including its cross-sectional design, which shows association but cannot establish cause and effect, and the use of some self-reported health behavior data. Additionally, because the study population intentionally included many individuals from disadvantaged backgrounds, the findings may not be generalizable to all young adults. Researchers say additional 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 website at heart.org.
