Youth alone is not enough to protect the heart. Last year, researchers studying a group of young people in the United States made an “alarming” observation. Examinations and measurements of the carotid arteries in over a thousand young participants revealed signs of subclinical damage. Some arterial thickness readings corresponded to those expected in a 33-year-old, even though the participants’ average age was 23.
Now, a follow-up study of the same cohort may explain why this potential damage occurs in adults under the age of 30.
The study, published in the journal Circulation: Population Health and Outcomes, found that 80 percent of the 1,283 young people involved were diagnosed with cardiovascular-kidney-metabolic (CKM) syndrome.
The more advanced the stage of CKM syndrome, the more likely participants were to show signs of damage to the carotid arteries, which supply oxygen-rich blood to the brain.
These findings are concerning and may explain the rising incidence of cardiovascular, metabolic, and kidney diseases among young people.
However, these specific participants do not represent the entire young population of the United States. The study focused on an urban population, and many participants came from disadvantaged backgrounds.
“Metrics regarding nutrition and physical activity were particularly poor,” the study authors noted.
This increases the risk of CKM syndrome among the study participants.
CKM syndrome was first described by the American Heart Association (AHA) in 2023, and it was only this year that the AHA and the American College of Cardiology published the first clinical guidelines for the prevention and treatment of the syndrome. CKM is a syndrome that explains how metabolic, renal, and cardiovascular disorders can interact, contributing to the development of multi-organ complications and dangerous cardiovascular consequences.
“Heart, kidney, and metabolic diseases do not occur in isolation—they are closely interconnected,” explained Chiadi Ndumele of the Johns Hopkins School of Medicine when these guidelines were published.
The stages of CKM range from risk factors—such as prediabetes or excess adipose tissue—to risk factors for metabolic disorders, kidney disease, and, finally, cardiovascular disease.
None of the young participants in this study were diagnosed with this final stage of CKM. However, some were at a more advanced stage of the condition than others.
This means they had more shared risk factors for developing chronic kidney disease or cardiovascular diseases, such as coronary heart disease, heart failure, or stroke.
Of the 1,283 participants, 40 percent were classified as being in Stage 1 of CKM, 36 percent in Stage 2, and 2.8 percent in Stage 3.
A CKM diagnosis does not mean these participants are doomed, but it indicates that they are on a high-risk trajectory.
“Young people cannot afford to ignore this,” asserts study co-author Nilay Shah of Northwestern University. “Many components of CKM begin to affect people at a younger age—as early as young adulthood or even adolescence.” In a recent study on CKM, risk factors in young people were measured using “Life’s Essential 8″—a composite metric comprising diet quality, physical activity, sleep, nicotine exposure, body mass index, blood sugar levels, blood lipids, and blood pressure.
Managing these factors is known to reduce the risk of cardiovascular disease and support kidney and metabolic health.
Much like the “Life’s Essential 8” scale, the CKM stages are expected to help identify individuals at risk of developing disease in the future, as well as any risk factors that can be treated or modified.
CKM progression may be reversible with appropriate health interventions—such as improving diet, increasing physical activity, or taking medication to boost metabolism.
“Although many young people do not yet have elevated levels of clinically apparent risk factors… many still offer opportunities to optimize risk factors through lifestyle and behavioral changes,” the study authors conclude.
Youth does not last forever, and our health during our younger years can shape our future. It is never too early to start.
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