Younger Adults Disproportionately Not Treated for Cardiometabolic Risk Factors | ADA 2025
When compared with adults 45 years and older, those 18 to 44 years are less likely to receive treatment or achieve target goals for cardiometabolic risk factors.
Cardiometabolic risk factors, including type 2 diabetes (T2D), obesity, hypertension, dyslipidemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), are rising among younger adults in the United States.
In a study published in the Journal of the American Heart Association, investigators noted the prevalence of lifestyle risk factors associated with cardiometabolic diseases from 2011 to 2018 included 22% for current smokers, 16.3% for excessive drinking, 49.3% for poor diet quality, 25.7% for inadequate physical activity, and 35.8% for inappropriate sleep duration. The prevalence of having none of the lifestyle risk factors was 20.1%, compared with 45.2% having 2 or more.1
When compared with adults 45 years and older, those 18 to 44 years are less likely to receive treatment or achieve target goals for cardiometabolic risk factors. | Image Credit: neirfy - stock.adobe.com
Although there are guideline-directed medical therapies for the prevention of cardiovascular diseases, investigators state that it is not clear if younger adults are treated with the same care. The investigators of a study presented as a poster at the American Diabetes Association 85th Scientific Sessions aimed to assess the prevalence and treatment of cardiometabolic risk factors for young adults compared with older adults.1
Investigators included a total of 1453 individuals that were attending primary care or endocrinology clinics, either with or without T2D. Investigators analyzed medical history, physical examinations, and laboratory testing as well as self-reported presence of cardiometabolic risk factors or treatment for them. Young adults were patients aged 18 to 44 years old and older adults were 45 years or older.1
Of 250 younger patients, the mean age was 38 years, 57% were female, 68% were obese, 42% had T2D, 60% had hypertension, 80% had dyslipidemia, and 58% had MASLD. Approximately 93% were on treatment for T2D, 63% were on treatment for hypertension, and 32% were on treatment for dyslipidemia. For 1203 older patients, the mean age was 61 years, 57% were female, 57% were obese, 69% had T2D, 84% had hypertension, 92% had dyslipidemia, and 59% had MASLD. For treatment, approximately 89%, 83%, and 72% received treatment, respectively.1
Investigators found that, even with the prevalence of cardiometabolic risk factors, younger adults are less likely to receive treatment or achieve the target goals when compared with older adults. Younger patients on treatment had a hemoglobin A1c of 7.9% compared with older adults at 7.4%. For those not receiving treatment, hemoglobin A1c was 6.2% and 6.4%, respectively. For low-density lipoprotein cholesterol of less than 70 mg/dL, it was achieved by 23% of young patients on treatment and 40% of older patients compared with 0% and 14% not on treatment, respectively. For hypertension, the patients achieving the target outcome were 74% and 89%, respectively, compared with 26% and 11%, respectively.1
Furthermore, the investigators concluded that the prevalence of MASLD and clinically significant fibrosis for younger patients was comparable to older adults with T2D, with the percentage of individuals with MASLD being 64% and 61%, respectively, and 14% and 12%, respectively. The investigators stated that further research is needed to help address the barriers of cardiovascular risk reduction for younger adults with cardiometabolic risk factors.1
Read more from our coverage of the ADA’s 85th Scientific Sessions.
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