Early Cardiovascular Multimorbidity in Young Adults: Emerging Risk Profiles, Lifelong Exposure, and Strategies for Early Detection

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Abstract
Cardiovascular multimorbidity in young adults is an increasingly relevant clinical and public health concern because multiple cardiovascular, metabolic, renal, behavioral, and psychosocial risk factors may coexist long before overt cardiovascular disease becomes clinically evident. This study analyzed the emerging burden of cardiovascular multimorbidity in young adults, emphasizing conventional and emerging risk factors, early detection strategies, and population-level consequences. An integrative literature review was conducted using recent epidemiological studies, prospective cohorts, systematic reviews, scientific statements, and contemporary cardiovascular risk frameworks. The evidence showed that obesity, dyslipidemia, hypertension, impaired glucose metabolism, nicotine exposure, physical inactivity, poor sleep, and psychosocial factors frequently cluster during early adulthood. Additional markers such as apolipoprotein B, lipoprotein(a), renal dysfunction, central adiposity, and cumulative low-density lipoprotein cholesterol exposure may provide complementary information regarding long-term cardiovascular vulnerability. The findings also demonstrated that short-term cardiovascular risk estimates may underestimate the lifetime impact of prolonged exposure to multiple risk factors in younger individuals. Early detection therefore requires a multidimensional approach integrating clinical, anthropometric, laboratory, behavioral, familial, and social information. From a population perspective, the early onset of multimorbidity may increase future cardiovascular events, chronic healthcare utilization, premature disability, and economic burden. A life-course approach to cardiovascular prevention, focused on early recognition and reduction of cumulative risk exposure, may improve long-term cardiovascular health and limit progression toward established cardiovascular disease.