Nearly eight in 10 participants in a U.S. study of young adults had at least an early stage of cardiovascular-kidney-metabolic syndrome, and those at more advanced stages showed signs of arterial injury, researchers reported on Thursday. The peer-reviewed findings, published in Circulation: Population Health and Outcomes, suggest that risk assessment and prevention may need to begin well before age 30.
Researchers analyzed health data from 1,283 participants in the Future of Families–Cardiovascular Health Among Young Adults study. The diverse cohort had an average age of 23. They assigned each person a CKM stage, assessed cardiovascular health with the American Heart Association's Life's Essential 8 score and used ultrasound images of the carotid arteries in the neck to look for early damage.
About 21% of participants had no identifiable CKM risk factors and qualified for stage 0. Nearly 80% met the criteria for stages 1, 2 or 3, indicating excess body fat, metabolic risk factors or evidence of cardiovascular disease that had not yet produced symptoms. No participant had stage 4, which covers established cardiovascular conditions.
Participants in higher CKM stages also had poorer Life's Essential 8 scores and thicker carotid artery walls, an early marker of atherosclerosis. CKM syndrome describes the linked effects of obesity, diabetes, chronic kidney disease and cardiovascular disease. The eight health measures include diet, physical activity, nicotine exposure, sleep, weight, cholesterol, blood sugar and blood pressure.
The researchers said the two assessment systems can complement one another in identifying people under 30 who may be progressing toward plaque buildup and later cardiovascular events. Their conclusions align with a 2026 joint clinical guideline that recommends CKM staging for young people and adults, alongside routine checks of metabolic risks and kidney function.
The authors cautioned that the study cannot prove that a higher CKM stage caused the arterial changes because it measured participants at one point in time. Some behavior data were self-reported, and the deliberate inclusion of many people from disadvantaged backgrounds means the results may not represent all young adults. Longer studies are needed to determine whether early CKM stages predict later heart disease.
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