# 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.

_Source: Peer-reviewed cross-sectional cohort analysis; verified against PubMed, Europe PMC and Crossref · 2026-09-21 · 6 min read · Verified against primary sources_

Canonical: https://iyu.app/e/young-adults-ckm-stage-carotid-markers

## 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.

## Full explainer

> **⚑ Caveat:** This was a cross-sectional association study. Carotid ultrasound markers are not heart attacks or strokes, and the analysis cannot show that CKM stage caused artery changes.


### Snapshot — Risk 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.

- **1,283** — young adults studied
- **22.9** — mean age in years
- **20.7%** — classified as Stage 0


### Stages — What 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.

> **i** Stage 1 is a prevention category. It does not mean that 40.2% of these young adults had diagnosed heart disease.


### Associations — Health 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.


### Limits — A 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.


### Action — Prevention 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.


## Primary sources

- [Telegram post 1497](https://t.me/CNSmydream/1497)
- [Circulation: Population Health and Outcomes paper](https://doi.org/10.1161/CIRCOUTCOMES.125.013042)
- [PubMed record](https://pubmed.ncbi.nlm.nih.gov/42619589/)
- [Europe PMC record](https://europepmc.org/article/MED/42619589)

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