Cardiovascular-Kidney-Metabolic (CKM) Risk Is Already Evident in Young Adults: Study
USA: A cohort study of young adults from disadvantaged urban backgrounds found that only about 20% of participants around age 22 had no CKM risk factors. Increasing CKM stage was associated with a greater burden of cardiovascular risk factors and early evidence of arterial injury. These findings provide further support for the CKM staging framework, suggesting that cardiovascular, kidney, and metabolic risk can accumulate surprisingly early in adulthood and may help identify individuals who could benefit from early preventive interventions.
The study, published in Circulation: Cardiovascular Quality and Outcomes, evaluated the American Heart Association’s CKM Syndrome staging system in young adults and its association with cardiovascular health and carotid artery changes.
Led by Vaishnavi Krishnan of Boston University Chobanian & Avedisian School of Medicine and colleagues, the study analyzed 1,283 FF-CHAYA participants with a mean age of 22.9 years; 54.4% were women. CKM stages were assessed using the AHA framework, while cardiovascular health was measured using Life’s Essential 8 (LE8), covering diet, physical activity, sleep, nicotine exposure, BMI, blood glucose, blood lipids and blood pressure.
Only 20.7% of participants were at CKM Stage 0 with no risk factors. Stage 1 was identified in 40.2% and reflected excess adiposity, while 36.2% were at Stage 2 with metabolic risk factors. Stage 3, indicating subclinical cardiovascular disease or advanced kidney disease, was present in 2.8% of participants.
Key findings included:
- Participants with Stage 1 CKM had LE8 scores 7.6 points lower than those at Stage 0.
- Stage 2 was associated with a 13.9-point lower LE8 score, while Stage 3 showed a 13.2-point lower score.
- Participants in CKM Stages 1 through 3 had greater carotid intima-media thickness, an indicator of early arterial changes, compared with Stage 0.
- Mean-maximum carotid intima-media thickness was 0.014 mm higher in Stage 1, 0.020 mm higher in Stage 2, and 0.100 mm higher in Stage 3 than in Stage 0.
- Lower gray-scale median values were also observed in participants with more advanced CKM stages, suggesting differences in carotid arterial characteristics.
The researchers cautioned that the findings may have limited generalizability because the cohort oversampled disadvantaged young adults. The cross-sectional design precludes causal conclusions, while multiple outcomes may increase the risk of chance findings. Long-term studies are needed to determine whether CKM stages predict future cardiovascular and metabolic outcomes.
The findings highlight the need for earlier prevention, particularly by addressing excess adiposity and related risk factors. The researchers noted that CKM staging and Life’s Essential 8 (LE8) complement each other—CKM guides management of cardiovascular, kidney and metabolic risks, while LE8 provides actionable lifestyle targets.
Overall, CKM risk is common in early adulthood, with advanced stages associated with early arterial changes, highlighting the potential value of earlier lifestyle and population-level interventions to prevent future cardiovascular, kidney and metabolic disease.
Reference: https://doi.org/10.1161/CIRCOUTCOMES.125.013042
Next Story