Scientists Find “Ominous” Signs of Artery Damage in Surprisingly Young Adults

Youth alone is not enough to safeguard the heart.

Last year, researchers studying a group of young adults in the United States made an "ominous" finding.

After imaging and measuring the carotid arteries of more than a thousand participants, they detected evidence of subclinical damage. Some measures of arterial thickness matched what might be expected in a 33-year-old, despite the group having an average age of 23.

A follow-up investigation of the same group may now offer an explanation for why these possible injuries are emerging in adults younger than 30.

Magnetic resonance angiography of cerebral artery and common carotid artery. (Paul Biris/Moment/Getty Images)

CKM syndrome and carotid artery damage in young adults

The research, published in Circulation: Population Health and Outcomes, reported that as many as 80 percent of 1,283 young adults were classified as having cardiovascular-kidney-metabolic (CKM) syndrome.

Participants at more advanced CKM stages were more likely to show indications of damage to their carotid arteries, which deliver oxygen-rich blood to the brain.

This is a worrying result and could help account for the increasing incidence of cardiovascular, metabolic and kidney conditions among younger groups.

However, these participants do not reflect every young person in the United States. The research concentrated on urban communities, and many of those involved were from disadvantaged backgrounds.

"Diet and physical activity scores were especially poor," the researchers noted.

That pattern places participants at greater risk of CKM.

If CKM syndrome is unfamiliar, that is not unusual. A US national survey conducted last year found that 90 percent of respondents had not heard of it either.

What cardiovascular-kidney-metabolic syndrome means

The American Heart Association (AHA) first defined CKM in 2023. Only this year did the AHA and the American College of Cardiology release the first clinical guidelines for preventing and managing the syndrome.

CKM describes the ways metabolic, kidney and cardiovascular disorders can interact, contributing to complications across multiple organs and serious cardiovascular outcomes.

"Heart, kidney, and metabolic conditions don't occur in isolation – they are deeply connected," Chiadi Ndumele, a cardiologist at Johns Hopkins School of Medicine, explained when the guidelines were issued.

CKM stages range from risk factors such as prediabetes or excess fat, through risks for metabolic and kidney disorders, and ultimately to cardiovascular disease.

No young adult in the present research had been diagnosed with this final CKM stage. Yet some participants were further along this continuum than others.

In other words, they had a greater overall number of risk factors for chronic kidney disease or cardiovascular disease, including coronary heart disease, heart failure and stroke.

Of the 1,283 participants, 40 percent were classified as stage 1 CKM, 36 percent as stage 2, and 2.8 percent as stage 3.

There are four stages of CKM syndrome. These stages identify risk and tailor prevention strategies to slow, or even reverse, progression of CKM syndrome. (AHA)

Having CKM does not mean these participants are doomed, but it does indicate that they are following a higher-risk course.

According to co-author and Northwestern University cardiologist Nilay Shah, it is not an issue young people can afford to overlook.

"So many of the components of CKM are starting to affect people at younger ages – as early as young adulthood, or even adolescence," Shah explained late last year.

Risk factors and opportunities to reverse CKM progression

In the latest CKM research, the young adults' risk factors were assessed with "Life's Essential 8 scores", a combined measure covering diet quality, physical activity, sleep, nicotine exposure, body mass index, blood sugar levels, blood lipids and blood pressure.

Controlling these measures is known to lower heart-disease risk while supporting kidney and metabolic health.

As with a Life's Essential 8 score, CKM stages are intended to help identify people at risk of future illness, along with risk factors that may be treated or altered.

With appropriate health interventions, CKM progression may be reversible, including through dietary improvements, more exercise or medicines that enhance metabolism.

Related: Major Study Links 99% of Heart Attacks And Strokes With 4 Risk Factors

"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 study authors conclude.

Youth does not last indefinitely, and health in early life can influence what follows. It is never too early to begin.

The study appears in Circulation: Population Health and Outcomes.

This article was fact-checked and edited by Clare Watson. Although we take pride in our process, we are only human. If you notice an error, please let us know.