Most people file heart disease under problems for later in life, something to think about in their 50s or 60s. New research on young adults suggests that timeline deserves a second look. It also points to a condition that links your heart to other systems in your body, one that most people have never heard of and that can be developing well before you notice anything. Here is what scientists found, and what you can do about it.
Young Adults, Aging Arteries
Researchers in the US imaged the carotid arteries of more than 1,000 young adults. These are the arteries in your neck that carry oxygen-rich blood to your brain. The participants averaged 23 years old, and the scans still showed signs of injury. Some measures of artery wall thickness matched what you would expect in a 33-year-old. The study authors called the finding “ominous.”
Doctors call this kind of damage subclinical. It causes no symptoms and doesn’t count as a disease yet, but it shows up on imaging and raises the odds of heart and blood vessel problems down the road.
A follow-up study on the same group looked for a reason. Of 1,283 young adults, about 79 percent met the criteria for cardiovascular-kidney-metabolic (CKM) syndrome, a condition that ties together heart, kidney, and metabolic health problems. Around 40 percent were at stage 1, 36 percent at stage 2, and 2.8 percent at stage 3. No one had reached the final stage, which involves diagnosed cardiovascular disease.
The pattern was consistent. The further along a participant was in CKM, the more likely they were to show injury in the carotid arteries. The follow-up was published in Circulation: Population Health and Outcomes.
What CKM Syndrome Is and How It Progresses
CKM stands for cardiovascular-kidney-metabolic syndrome. It describes how your heart, kidneys, and metabolism affect one another. A problem in one system raises the odds of problems in the other two, and together they can lead to damage across multiple organs and dangerous cardiovascular outcomes. As Chiadi Ndumele, a cardiologist at Johns Hopkins, put it, these conditions don’t occur in isolation.
The American Heart Association (AHA) first defined CKM in 2023. This year, the AHA and the American College of Cardiology published the first clinical guidelines for preventing and managing it. Public awareness is far behind. A US national survey found that 90 percent of respondents had never heard of the condition.
CKM moves through stages. It starts with risk factors such as prediabetes or excess body fat. It then advances to risk factors for metabolic disorders and kidney disorders. The final stage is cardiovascular disease, which includes coronary heart disease, heart failure, and stroke.
A higher stage means a person has more risk factors for chronic kidney disease and cardiovascular disease. The staging system exists to flag who is at risk of future disease and to point out which risk factors can be treated or changed. In other words, a stage tells you where someone is heading if nothing changes, not just where they are today.
The Caveats That Matter
These results come with limits, and you should know them before drawing conclusions. The participants are not representative of all young people in the US. The study focused on urban populations, and many participants came from disadvantaged backgrounds. The authors noted that diet and physical activity scores in the group were especially poor. Both raise the risk of CKM, so a high rate of the syndrome in this group is not surprising. Your own risk depends on your own habits, health history, and circumstances.
Still, the findings point to a real shift. Cardiovascular, metabolic, and kidney disorders are becoming more common in younger age groups, and this research may help explain why. Nilay Shah, a cardiologist at Northwestern University and a co-author, says many components of CKM now begin to affect people in young adulthood, or even in adolescence. Doctors have long treated these conditions as problems of middle age and later. The data says the process can start decades earlier.
A CKM diagnosis does not mean a person is doomed. It does mean they are on a risky path, and Shah argues young people can’t afford to ignore it. Most of the young adults in this study had no diagnosed disease and likely felt fine. That is the point. Artery injury and rising risk can build for years without producing a single symptom.
How to Measure and Lower Your Risk
The researchers measured each participant’s risk using Life’s Essential 8, a score built from eight factors: diet quality, physical activity, sleep, nicotine exposure, body mass index, blood sugar, blood lipids (cholesterol and related fats), and blood pressure. Four of these are habits you control directly. The other four are numbers a simple checkup can give you. Managing all eight is known to lower the risk of heart disease and to support kidney and metabolic health.
The key message from the study authors is that many young adults don’t yet have clinically elevated levels on these factors. Their numbers may fall in the normal range, but there is still room to improve them through changes in lifestyle and behavior. You don’t need a diagnosis to make that worthwhile.
CKM can also move in the right direction. Its progression may be reversible with the right interventions: improving your diet, exercising more, or taking medications that improve metabolism. The earlier you start, the more time you have to slow it down.
Here is what I’d do in practice. Ask your doctor for your blood pressure, blood sugar, and cholesterol numbers, and keep track of them over time, even if you feel healthy. Then look at the four habits in the score (food, movement, sleep, and nicotine) and pick the one where you have the most room to improve.
Health in your twenties and thirties shapes health later in life, and it’s never too early to start.
My Personal RX on Protecting Your Heart in Your 20s and 30s
You don’t need a diagnosis to protect your heart, kidneys, and metabolism. The habits you build now shape how your arteries look later. Here is what I’d start with.
- Know Your Numbers:Β Ask for blood pressure, blood sugar, and cholesterol tests at your next checkup. Keep the results and compare them year over year.
- Move Every Day:Β Aim for 150 minutes of moderate activity a week. Brisk walks count.
- Build Meals From Whole Foods:Β Center them on vegetables, beans, fish, nuts, and whole grains. Cut back on sugary drinks and processed snacks.
- Fill Nutrient Gaps:Β Food comes first, but my Core Four Bundle adds omega-3 fish oil, calcium and magnesium, vitamin D3 + K2, and MindBiotic to support heart health, energy, and digestion.
- Protect Your Sleep:Β Keep a consistent bedtime and wake time, and aim for seven or more hours a night.
- Quit Nicotine:Β Vaping counts. Ask your doctor about support if you’re trying to stop.
- Support Your Metabolic Health:Β MetaBurn supports cardiometabolic function, including blood pressure, blood sugar, and cholesterol balance, alongside diet and exercise.
- Manage Stress:Β Take 10 minutes a day for slow breathing or a walk without your phone.
- Drink Water, Limit Alcohol:Β Water supports your kidneys. Heavy drinking raises blood pressure.
- Learn How Your Gut Connects to Your Health:Β My bookΒ Heal Your Gut, Save Your BrainΒ explains how gut health ties into whole-body health, including your metabolism.
Sources:
- Cassella, C. (2026, August 27).Β Scientists Find Signs of Artery Damage in Nearly 8 in 10 Young Adults. ScienceAlert. https://www.sciencealert.com/scientists-find-ominous-signs-of-artery-damage-in-nearly-8-in-10-young-adults
- LloydβJones, D. M., Allen, N. B., Stein, J., Ning, H., Hansen, K., Hou, L., Katchur, N. J., Korcarz, C., Kotenko, I., Little, S., Mitchell, C., Rooney, J., Savas, H., Schneper, L., Tawa, E., Van Horn, L., Zheng, Y., Tracy, R., Goldman, N., & Notterman, D. A. (2025). Future of Families: Cardiovascular Health Among Young Adults Cohort Study: Rationale, Key Questions, Study Design, and Participant Characteristics.Β Journal of the American Heart Association,Β 14(17). https://doi.org/10.1161/jaha.125.042030
