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Association of Cardiometabolic Multimorbidity With Mortality
, Emanuele Di Angelantonio1, Stephen Kaptoge1
1University of Cambridge, Cambridge, England.
JAMA
|July 8, 2015
Summary
Cardiometabolic multimorbidity significantly reduces life expectancy. Having two conditions like diabetes, stroke, or myocardial infarction (MI) cuts life expectancy by 12 years, while all three reduce it by 15 years.
Area of Science:
- Cardiovascular disease epidemiology
- Public health research
- Longevity studies
Background:
- Increasing prevalence of cardiometabolic multimorbidity poses a significant public health challenge.
- Understanding the impact of multiple cardiometabolic conditions on life expectancy is crucial for preventative strategies.
Purpose of the Study:
- To quantify the reduction in life expectancy associated with cardiometabolic multimorbidity.
- To analyze the mortality risks linked to combinations of diabetes, stroke, and myocardial infarction (MI).
Main Methods:
- Utilized individual participant data from the Emerging Risk Factors Collaboration (nearly 700,000 participants) and UK Biobank (500,000 participants).
- Calculated age- and sex-adjusted mortality rates and hazard ratios (HRs) for individuals with and without cardiometabolic conditions.
- Estimated cumulative survival by applying HRs to US age-specific death rates.
Main Results:
- A history of any two cardiometabolic conditions (diabetes, stroke, MI) at age 60 was linked to a 12-year reduction in life expectancy.
- Individuals with all three conditions (diabetes, stroke, MI) experienced a 15-year reduction in life expectancy at age 60.
- Mortality risk increased multiplicatively with each additional condition, with HRs for all-cause mortality ranging from 1.9 to 6.9 compared to the reference group.
Conclusions:
- Cardiometabolic multimorbidity substantially decreases life expectancy.
- The combined effect of diabetes, stroke, and MI on mortality risk is multiplicative, leading to significant reductions in longevity.
- Public health interventions should focus on preventing and managing these conditions to mitigate their impact on life expectancy.
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