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Trends in comorbidity in patients hospitalised for cardiovascular disease
Josefien Buddeke1, Michiel L Bots2, Ineke van Dis3
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Dutch Heart Foundation, The Hague, The Netherlands.
Insights
Comorbidities are common in cardiovascular disease (CVD) patients, especially older adults. While cardiovascular comorbidities decreased, cancer prevalence increased significantly in men and women between 2000-2010.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Investigating temporal trends in cardiovascular and non-cardiovascular comorbidities among hospitalized cardiovascular disease (CVD) patients.
- Understanding the evolving landscape of patient health beyond primary cardiovascular conditions.
Purpose of the Study:
- To determine trends in cardiovascular and non-cardiovascular comorbidity in patients hospitalized for CVD.
- To analyze these trends across different age groups, sexes, and specific CVD types (CHD, CVA, HF, PAD).
Main Methods:
- Utilized the Dutch nationwide hospital register for CVD hospitalizations from 2000-2010.
- Defined comorbidity based on previous hospital admissions for specific conditions within five years prior to index CVD hospitalization.
- Analyzed trends stratified by age, sex, and CVD type: coronary heart disease (CHD), cerebrovascular disease (CVA), heart failure (HF), and peripheral arterial disease (PAD).
Main Results:
- Identified 2,397,773 CVD admissions; 38% had comorbidity, highest in HF (54%) and PAD (46%).
- Overall comorbidity increased by 1.1% from 2000-2010, most notably in patients aged ≥75 years (+3.0%).
- Cardiovascular comorbidity prevalence decreased (men -5%, women -2%), while non-cardiovascular comorbidity increased (men +4%, women -1%), with cancer showing a significant rise in both sexes (+5% men, +4% women).
Conclusions:
- Comorbid conditions are highly prevalent in hospitalized CVD patients, particularly those with heart failure (HF) and peripheral arterial disease (PAD).
- Comorbidity prevalence increased over time, especially in older patients.
- While cardiovascular comorbidities decreased in prevalence, cancer comorbidity significantly increased, highlighting a shift in the comorbidity profile of CVD patients.
Background:
We determined trends over time in cardiovascular and non-cardiovascular comorbidity in patients hospitalised for cardiovascular disease (CVD).
Methods:
The Dutch nationwide hospital register was used to identify patients hospitalised for CVD during 2000-2010. Comorbidity was defined as a previous hospital admission for CVD other than the index CVD, cancer, diabetes, musculoskeletal and connective tissue disorders, respiratory disorders, thyroid gland disorders, kidney disorders and dementia in the five years previous to hospital admittance for the index CVD. Trends were calculated in strata of age and sex and for different types of CVD: coronary heart disease (CHD), cerebrovascular disease (CVA), heart failure (HF) and peripheral arterial disease (PAD).
Results:
We identified 2,397,773 admissions for CVD between 2000 and 2010. Comorbidity was present in 38%. In HF, PAD, CHD and CVA this was 54%, 46%, 40%, and 32%, respectively. Between 2000 and 2010, the percentage of patients with comorbidity increased (+1.1%), this increase was most pronounced in patients ≥75years (+3.0%). Cardiovascular disease was the most frequent comorbid condition, though became less prevalent over time (men -5%; women: -2%), whereas non-cardiovascular comorbidity increased in men (+4%), and remained similar in women (-1%). Cancer was the most common non-cardiovascular comorbid condition and increased in men and women (men: +5%; women: +4%).
Conclusions:
Comorbid conditions are highly prevalent in patients hospitalised for CVD, especially HF and PAD patients. In older patients, prevalences increased over time. Cardiovascular diseases were the most common comorbid condition, though the prevalence decreased over the study period whereas the prevalence of cancer increased.
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