Understanding the Rising Impact of Cardiovascular-Kidney-Metabolic Syndrome in Young Adults

Young adults are driving a sharp rise in cardiovascular–kidney–metabolic (CKM) disease and related healthcare costs. Expenditures rose 37% for ages 25–29 and 39% for ages 30–34 between 2010 and 2019, a shift that signals increased primary care workload and higher system costs ahead.

This pattern breaks from the expectation that CKM multimorbidity is mainly a problem of older adults. CKM—where cardiovascular, renal, and metabolic risks interact—now appears to be accumulating earlier, increasing lifetime disease burden and reducing workforce productivity when it begins in the 25–34 age band.

The data show the largest cost increases concentrated in the 25–34 cohort over 2010–2019, consistent with earlier accumulation of risk factors such as obesity, hypertension, dysglycemia, and albuminuria. That earlier risk accumulation likely underlies the observed economic shift.

Screening in younger adults should emphasize high-yield, modifiable measures: blood pressure, fasting lipids, glycemia (or HbA1c), urine albumin–creatinine ratio, BMI and waist circumference. Integrate brief CKM risk checklists into annual exams and use opportunistic windows—contraceptive, sports, or pre-employment visits—to capture at-risk patients. Use brief risk calculators (eg, pooled cohort/ASCVD estimator) and point-of-care testing (HbA1c devices, spot urine ACR) to streamline workflow and direct early intervention.

Health systems can blunt long-term burden with multidisciplinary pathways linking primary care, nephrology, cardiology and behavioral health. Deploy care navigators for high-risk young adults, structured follow-up for abnormal screening, and telehealth or remote monitoring for blood pressure and glucose to improve adherence and treatment timeliness. Coordinated care has potential to reduce downstream high-cost events and offset short-term investment through fewer hospitalizations.