Youth Isn’t a Shield for Heart Health

Last year, researchers looked into a group of young adults in the United States and found something quite alarming. They were imaging and measuring the carotid arteries of over a thousand participants and uncovered signs of subclinical injury—essentially, indicators that something was wrong.

To put it in perspective, some of the arterial thickness markers appeared like what you’d expect to see in a 33-year-old, while the average age of those involved in the study was just 23. Now, a follow-up examination of this same group might shed light on why these issues are manifesting in adults under 30.

Published in Circulation: Population Health and Outcomes, the study revealed that out of 1,283 young adults, up to 80 percent were found to have cardiovascular-kidney-metabolic (CKM) syndrome. The more advanced their CKM, the more signs of injury were seen in their carotid arteries, which are crucial for supplying oxygenated blood to the brain. This finding raises serious concerns about the increasing prevalence of cardiovascular, metabolic, and kidney conditions among younger people.

It’s important to note that these participants don’t represent all young adults in the U.S.; the focus was more on urban populations with many individuals coming from disadvantaged backgrounds. The authors of the study pointed out that both diet and physical activity levels were particularly poor among them, which clearly elevates their risk of CKM.

If you’re scratching your head about CKM, you’re not alone. A national survey last year indicated that 90 percent of respondents were unfamiliar with the condition.

First outlined by the American Heart Association (AHA) in 2023, the syndrome came into focus this year when the AHA and the American College of Cardiology published clinical guidelines for its prevention and management. CKM syndrome encapsulates how issues related to metabolic health, kidney function, and cardiovascular conditions can interrelate and lead to serious complications.

Chiadi Ndumele, a cardiologist at Johns Hopkins School of Medicine, explained that “heart, kidney, and metabolic conditions don’t occur in isolation—they are deeply connected.”

The stages of CKM begin with risk factors such as prediabetes or excess fat, progressing to metabolic and kidney disorders, and eventually leading to cardiovascular diseases. In the current study, none of the young adults had reached the final stage of CKM, but many were further along than others. This meant they had various risk factors for serious conditions like coronary heart disease or stroke.

From the group of 1,283, 40 percent were identified as stage 1 CKM, 36 percent were at stage 2, and 2.8 percent had reached stage 3. So, it doesn’t mean that these participants are on a doomed path, yet it does signal a concerning trajectory.

It’s something that young people should really take seriously, according to Nilay Shah, a cardiologist from Northwestern University. He highlighted that components of CKM are affecting individuals at younger ages—often as early as young adulthood or even adolescence.

In the latest CKM study, risk factors for young adults were evaluated using “Life’s Essential 8 scores,” which summarizes diet quality, physical activity, sleep, nicotine use, body mass index, blood sugar levels, blood lipids, and blood pressure.

Improving these aspects is known to lessen the chances of developing heart disease and can bolster kidney and metabolic health.

Similar to the scoring system, it’s hoped that the stages of CKM will help pinpoint those at risk for future diseases and identify treatable risk factors. With the right health interventions—like better eating habits, more exercise, or even medication to enhance metabolism—the progression of CKM could be reversed.

“Although many young adults may not yet have clinically elevated risk factor levels, many still present opportunities for risk factor optimization through lifestyle and behavioral modification,” the authors concluded.

Youth won’t stick around forever, and the health choices we make in our younger years can really dictate our futures. It’s never too early to start making changes.

This study is featured in Circulation: Population Health and Outcomes.