The risk of death was similar among patients with a history of diabetes, stroke, or myocardial infarction (MI), and the risk was significantly higher with each multimorbidity the patient had, a study published in JAMA has shown.
While there is considerable evidence regarding mortality risk in patients with one cardiometabolic condition, there have been scare findings on mortality among people who have two or three conditions. In the study, cardiometabolic multimorbidity was defined as a history of ≥2 of the following: diabetes mellitus, stroke, or MI. Research authors from the University of Cambridge calculated reductions in life expectancy linked to cardiometabolic multimorbidity. Individual participant data from the Emerging Risk Factors Collaboration (n=689,300) from 1960–2007 were used to calculate age- and sex-adjusted mortality rates and hazard ratios. The ratios were compared against those from the UK Biobank (n=499,808) from 2006–2010.
Data revealed that patients who had one condition had about twice the rate of mortality, about four times the mortality rate with two conditions, and about eight times with all three conditions compared to patients who did not have a history of any of the conditions. The reductions in life expectancy related to cardiometabolic multimorbidity are similar to those seen with exposure to major public health concerns such as lifelong smoking (10 years reduced), and HIV infection (11 years reduced). Higher reductions were estimated for patients with multimorbidity at younger ages.
In regards to gender, men had a stronger association between baseline cardiovascular disease and reduced survival whereas women had a stronger association between baseline diabetes and reduced survival. About 60% of reduced life expectancy from cardiometabolic multimorbidity was due to cardiovascular deaths for men vs. about 45% for women.
Study findings emphasize the importance of balancing primary and secondary prevention of cardiovascular disease, researchers concluded.
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