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Advanced CKM stage is associated with worse cardiovascular health and early arterial injury in young adults

In the FF-CHAYA study of 1283 young adults (mean age 22.9 years), more advanced CKM stages (1-3) were associated with significantly lower Life's Essential 8 scores and higher carotid intima-media thickness (a marker of early arterial injury) compared to Stage 0. For example, mean-maximum carotid intima-media thickness was 0.014 mm higher for Stage 1, 0.020 mm higher for Stage 2, and 0.100 mm higher for Stage 3 compared to Stage 0.

Last updated: Aug 25, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association Between Cardiovascular-Kidney-Metabolic Health and Early Arterial Injury in Young Adults in the United States: The Future of Families-Cardiovascular Health Among Young Adults Study.

observational

Krishnan V, Ning H, Notterman DA, Goldman N, Khan SS, Shah NS, Allen NB, Lloyd-Jones DM · Circulation. Population health and outcomes (2026)

Participants: N/A
Duration: Cross-sectional
Intervention: CKM staging (Stage 0 to 3) based on AHA framework
Outcome: Life's Essential 8 scores, carotid intima-media thickness (mean-mean and mean-maximum), gray scale median
Effect Size: Mean-maximum carotid intima-media thickness difference: Stage 1: 0.014 mm (95% CI 0.005-0.020), Stage 2: 0.020 mm (95% CI 0.017-0.035), Stage 3: 0.100 mm (95% CI 0.085-0.128) compared to Stage 0
Population: Young adults in the United States (mean age 22.9 years, 54.4% women)

Result:

PubMed: 42619589DOI: 10.1161/CIRCOUTCOMES.125.013042

Mechanism Graph

CKM staging categorizes individuals based on presence of risk factors (Stage 0: none, Stage 1: excess adiposity, Stage 2: metabolic risk factors, Stage 3: subclinical CVD or advanced kidney disease)
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Higher CKM stage is associated with lower Life's Essential 8 scores (worse cardiovascular health)
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Higher CKM stage is associated with increased carotid intima-media thickness and lower gray scale median (early arterial injury)
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Result: Advanced CKM stage correlates with early arterial injury in young adults

Limitations

  • ⚠Cross-sectional design, so causality cannot be inferred
  • ⚠Single-center study (FF-CHAYA) may limit generalizability to all US young adults
  • ⚠CKM staging may not fully capture all aspects of cardiovascular health in this age group

Frequently Asked Questions

What is CKM syndrome?▼

CKM (Cardiovascular-Kidney-Metabolic) syndrome is a novel construct introduced by the American Heart Association that integrates cardiovascular, kidney, and metabolic health into a staging framework.

How was CKM stage determined in this study?▼

CKM stages were defined using the American Heart Association's framework: Stage 0 (no risk factors), Stage 1 (excess adiposity), Stage 2 (metabolic risk factors), Stage 3 (subclinical cardiovascular disease or advanced kidney disease).

What is Life's Essential 8?▼

Life's Essential 8 is a composite metric consisting of dietary quality, physical activity, sleep, nicotine exposure, body mass index, blood glycemia, blood lipids, and blood pressure.

What does carotid intima-media thickness indicate?▼

Carotid intima-media thickness is a measure of early arterial injury and subclinical atherosclerosis, with higher values indicating worse arterial health.

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References

  1. 1.Krishnan V, Ning H, Notterman DA, Goldman N, Khan SS, Shah NS, Allen NB, Lloyd-Jones DM. "Association Between Cardiovascular-Kidney-Metabolic Health and Early Arterial Injury in Young Adults in the United States: The Future of Families-Cardiovascular Health Among Young Adults Study.." Circulation. Population health and outcomes, 2026. PMID: 42619589 DOI: 10.1161/CIRCOUTCOMES.125.013042
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.