A new 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, average age 23, have cardiovascular-kidney-metabolic syndrome (CKM syndrome). The research, which assessed participants from the Future of Families–Cardiovascular Health Among Young Adults (FF-CHAYA) study, also discovered that those with more advanced CKM syndrome stages showed early signs of arterial injury, emphasizing the urgent need for cardiovascular disease prevention to start earlier in life.
The study evaluated 1,283 participants using two measures: CKM syndrome staging and the American Heart Association's Life's Essential 8™ cardiovascular health score. Ultrasound imaging of the carotid arteries revealed that participants with higher CKM stages had 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., a cardiologist at Boston Medical Center and professor at Boston University's Chobanian & Avedisian School of Medicine.
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). In this study, nearly 80% of participants were in stages 1-3, meaning they already had excess adiposity, metabolic risk factors, or subclinical cardiovascular disease. None were in stage 4.
Lloyd-Jones noted that standard risk assessment tools like the PREVENT™ equations are not applicable to those under 30, so the focus should be on optimizing Life's Essential 8 metrics. These include 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,” he said, adding that these metrics help individuals understand how lifestyle choices influence heart, kidney, and metabolic health over time.
The study's findings are particularly concerning given the rising rates of obesity and metabolic syndrome in young populations. According to the American Heart Association, obesity rates in the U.S. climbed to about 40% of adults and 20% of youth in 2023. This study underscores the importance of early intervention, as arterial damage can begin in young adulthood, long before clinical cardiovascular disease manifests.
Study limitations include its cross-sectional design, which cannot establish causation, and the use of self-reported health behavior data. The cohort also intentionally included many individuals from disadvantaged backgrounds, so 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.
Lloyd-Jones recommends that clinicians discuss Life's Essential 8 with young patients to improve health today and long-term. The findings were published ahead of the American Heart Association's release of its first-ever guideline on cardiovascular-kidney-metabolic syndrome, issued in June 2026, which provides a framework for preventing and managing these interconnected conditions.
For more information on CKM syndrome and cardiovascular health, visit the American Heart Association's CKM health resources and Life's Essential 8 pages.
