In an analysis that included nearly 1.2 million participants and more than 135,000 deaths, mortality associated with a history of diabetes, stroke, or heart attack was similar for each condition, and the risk of death increased substantially with each additional condition a patient had, according to a study in the July 7 issue of JAMA.
The prevalence of cardiometabolic multimorbidity (defined in this study as a history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction [MI; heart attack]) is increasing rapidly. Considerable evidence exists about the mortality risk of having any 1 of these conditions alone. However, evidence is sparse about life expectancy among people who have 2 or 3 cardiometabolic conditions at the same time, according to background information in the article.
John Danesh, F.Med.Sci., of the University of Cambridge, England, and colleagues estimated reductions in life expectancy associated with cardiometabolic multimorbidity. Age- and sex-adjusted mortality rates and hazard ratios (HR) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The hazard ratios from this study population were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7,995 deaths).
Among the primary findings:
The authors write that their results highlight the need to balance the primary prevention and secondary prevention of cardiovascular disease. "About 1 percent of the participants in the cohorts we studied had cardiometabolic multimorbidity compared with an estimate of 3 percent from recent surveys in the United States. There are currently an estimated 10 million adults in the United States and the European Union with cardiometabolic multimorbidity. Nevertheless, an overemphasis on the substantial reductions in life expectancy estimated for the subpopulation with multimorbidity could divert attention and resources away from population-wide strategies that aim to improve health for the large majority of the population."
Cite This Page: