CKM risk factors already track artery markers at age 23
In 1,283 US young adults, higher cardiovascular-kidney-metabolic stages were associated with poorer health scores and thicker carotid walls, but the cross-sectional study cannot show cause or predict an individual's future event.
The 60-second version
Higher CKM stages were associated with poorer health scores and less favourable carotid ultrasound markers in young adults, but causation and future events were not tested.
Key points
- The cross-sectional US analysis included 1,283 people with a mean age of 22.9.
- Only 20.7% were Stage 0; most were Stage 1 or 2.
- Higher stages tracked lower Life's Essential 8 scores and thicker carotid walls.
- Stage 1 mainly reflected excess adiposity, not diagnosed cardiovascular disease.
- Group-level ultrasound differences do not predict an individual's outcome.
Verdict. A strong case for earlier, equitable prevention and measurement, not for panic or self-diagnosis.
SnapshotRisk factors were common by the early twenties
Among 1,283 participants averaging 22.9 years old, fewer than one in four had no CKM risk factors. Most were classified as Stage 1 or 2, reflecting excess adiposity or metabolic risk rather than established symptomatic disease.
StagesWhat the categories meant
| Stage 0 | No CKM risk factors; 20.7% of participants. |
|---|---|
| Stage 1 | Excess adiposity; 40.2% of participants. |
| Stage 2 | Metabolic risk factors; 36.2% of participants. |
| Stage 3 | Subclinical cardiovascular disease or advanced kidney disease; 2.8% of participants. |
AssociationsHealth scores and artery markers moved together
Compared with Stage 0, Life's Essential 8 scores were 7.6 points lower at Stage 1, 13.9 lower at Stage 2 and 13.2 lower at Stage 3. The score combines behaviours and clinical factors, so overlap with CKM staging is expected.
| Stage 1 vs Stage 0 | Maximum carotid intima-media thickness was 0.014 mm higher on average. |
|---|---|
| Stage 2 vs Stage 0 | The average difference was 0.020 mm. |
| Stage 3 vs Stage 0 | The average difference was 0.100 mm, based on the smallest group. |
LimitsA marker is not a future event
- No time order: risk factors and ultrasound were assessed cross-sectionally.
- No individual prediction: group averages cannot say who will develop disease.
- Small Stage 3 group: only 2.8% were in the most advanced category.
- Generalizability: one US cohort may not represent all young adults.
The study argues for earlier prevention, not for labelling a generation as already diseased.
ActionPrevention starts with interpretable measurements
Blood pressure, glucose and lipids can be assessed when appropriate, alongside sleep, activity, diet and nicotine exposure. A clinician should interpret these with family history and social context; a headline is not enough to self-diagnose a CKM stage.