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

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.