What is CKM syndrome, and why should young adults pay attention?

If you’re unfamiliar with cardiovascular-kidney-metabolic syndrome, you’re hardly alone. But it might already be affecting you – no matter your age.

CKM syndrome describes a disorder due to connections among heart disease, kidney disease, diabetes and obesity. As spelled out in a 2023 presidential advisory from the American Heart Association, it affects nearly every organ system and is linked to problems including cognitive decline, kidney failure, heart attack, stroke and sudden cardiac death.

A recent national survey found that about 9 in 10 people were unfamiliar with CKM syndrome. But nearly that many adults also have at least one risk factor.

It’s not something younger people can ignore until they are older, said Dr. Nilay S. Shah, an assistant professor of cardiology and preventive medicine at Northwestern University's Feinberg School of Medicine in Chicago. “So many of the components of CKM are starting to affect people at younger ages – as early as young adulthood, or even adolescence.”

New research recently presented at the American Heart Association’s Scientific Sessions in New Orleans shows that CKM syndrome is increasingly affecting younger adults in the U.S. Between 2010 and 2019, the cost of related care rose 37% among those age 25 to 29 years and 39% among those 30 to 34. Such research is considered preliminary until full results are published in a peer-reviewed journal.

Shah, a preventive and general cardiologist who was not involved in the new research, helped explain why younger adults should be aware of their CKM health – and what they can do to help prevent CKM syndrome.

What is CKM health?

CKM refers to a spectrum of conditions related to the heart, kidneys and how the body processes energy, Shah said.

Those systems are closely connected. The heart pumps blood. The kidneys filter out waste and regulate blood pressure. Excess energy can get stored as fat and affect blood sugar levels, which can lead to problems that affect the heart and kidneys.

CKM has been described as a way to look at overall health instead of those individual components. When one component of CKM health functions poorly, it can make the others worse and put you at serious risk for CKM syndrome.

“All of these organs and body functions are related, and CKM helps us understand how well these body systems are functioning,” Shah said.

What are the risk factors for CKM syndrome?

Excess body fat is often the starting point for CKM syndrome. Body fat, or adipose tissue, can trigger inflammation that damages the heart, arteries, kidneys and liver. It also can lead to insulin resistance, which can result in Type 2 diabetes.

But while body fat is an important factor, it’s not the only one, Shah said. “CKM is a more comprehensive, bigger picture view of your health,” he said. And while excess body fat can contribute to people moving from being healthy toward heart disease, “it is one of many different components of what increases heart disease risk.”

Additional CKM risk factors include high blood pressure, abnormal cholesterol, high blood glucose and reduced kidney function.

How early in life should someone pay attention to risk factors for CKM syndrome?

Younger people who feel healthy might be inclined to ignore CKM risk factors. That would be a mistake, Shah said.

CKM syndrome is categorized by stages that reflect a person’s risk factors, ranging from 0 (no risk factors) to 4 (someone being treated for cardiovascular conditions such as coronary heart disease, heart failure or stroke). Research has shown that only 18% of people age 20 to 44 were at Stage 0.

So although CKM applies to people across all ages, Shah said, “starting to move from health toward disease can start as early as childhood, especially if children experience excess body weight, high blood sugar, high blood pressure or abnormalities in any function related to the heart or kidney systems.”

Why should a seemingly healthy young adult care about CKM syndrome?

Even if someone is healthy and does not have any CKM risk factors, Shah said, the most effective time to prevent heart disease and worse CKM health is early. Maintaining good habits in young adulthood “sets you up for good CKM health over your entire life.”

What can someone do to prevent CKM syndrome?

Eating a healthy diet, getting regular exercise, maintaining a healthy body weight and not smoking – “these are the cornerstones of maintaining overall CKM health,” Shah said.

Prevention also includes getting regular checkups and “knowing your numbers,” Shah said. “Talk to your doctor about what kinds of health conditions you should be screened for at your age. Many young people would be recommended to be screened for high blood pressure, high cholesterol and high blood sugar.”

Your doctor might also consider screening for any kidney problems, depending on your age or any other health conditions, he said. “If you are concerned about your weight, it’s important to start a conversation with your doctor about it.”

Understand that CKM syndrome can be stopped

Making healthy choices can help you take control of your risks, Shah said.

Preliminary results from a randomly controlled study, which also was presented at Scientific Sessions, showed that when healthy young adults cut the calories they consumed by 12%, the progress of CKM syndrome was limited or reversed.

“If you move from health toward disease on the CKM spectrum, it is possible to move back toward health,” Shah said. “Just because you have developed a heart disease risk factor like excess body weight, blood pressure or diabetes does not mean that these are necessarily permanent or lifelong.”

To learn more about the connection between CKM health and your overall health, visit the American Heart Association’s CKM Health page.