Trends in prevalence of cardiovascular-kidney-metabolic syndrome stages among US young adults, 2011–2020

Abstract

Background Cardiovascular-kidney-metabolic (CKM) syndrome is a multistage, multisystem disorder defined by the American Heart Association (AHA). We examined recent trends in CKM stages among US young adults aged 18–39 years and assessed disparities by age, sex, and race/ethnicity. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2011–2020. Individuals were classified into CKM stages 0–4 based on metabolic, cardiovascular, and kidney risk factors. Results Of the 7331 participants, 2202 (30.0%) were young adults. Among young adults, 48.2% were female and 56.9% non-Hispanic White. No significant temporal trends in CKM stage prevalence from 2011–2012 to 2017–2020 were observed among young adults and adults aged ≥40 years. In 2017–2020, among young adults, 20.4% (15.4% to 26.5%) had stage 0, 34.0% (28.5% to 40.0%) had stage 1, 44.4% (39.1% to 49.8%) had stage 2, and 1.2% had stage 3 or 4 CKM. Male and non-Hispanic Black young adults were more likely to have stage 2 or higher CKM compared to female and non-Hispanic White young adults. Among young adults with stage 2 CKM, 20.8% had stage 2 hypertension, 53.5% prediabetes, 3.4% diabetes, and 47.8% hypertriglyceridemia, and 8.9% high LDL-cholesterol ≥160 mg/dL; however, only 11.1% were on anti-hypertensive medications and 2.0% were on lipid-lowering medications. Conclusion Over 45% of US young adults had stage 2 or higher CKM, with notable disparities by sex and race/ethnicity. Identification of young adults with CKM allows opportunities for early screening and tailored interventions to prevent progression to clinically significant cardiovascular or kidney disease.