Related Experiment Video
Updated: Jul 15, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Prevalence and Overlap of Cardiac, Renal, and Metabolic Conditions in US Adults, 1999-2020
John W Ostrominski1, Suzanne V Arnold2, Javed Butler3,4
1Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts.
Insights
Cardiac, renal, and metabolic (CRM) conditions are increasingly common in US adults. This multimorbidity is undertreated, emphasizing the need for integrated management strategies.
Area of Science:
- Cardiovascular medicine
- Nephrology
- Endocrinology
- Public Health
Background:
- Cardiac, renal, and metabolic (CRM) conditions are leading causes of death, disability, and healthcare costs.
- The co-occurrence and prevalence of these conditions have not been fully characterized.
Purpose of the Study:
- To examine the prevalence and overlap of CRM conditions in US adults.
- To assess temporal trends in CRM condition co-occurrence.
Main Methods:
- Utilized nationally representative, serial cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2002 and 2015-2020.
- Included 11,607 nonpregnant US adults (≥20 years).
- Analyzed proportions of participants with cardiovascular disease (CVD), chronic kidney disease (CKD), and type 2 diabetes (T2D), individually and in combination.
Main Results:
- Between 2015-2020, 26.3% of US adults had at least one CRM condition, 8.0% had at least two, and 1.5% had all three.
- The most common dyad was CKD plus T2D (3.2%).
- Multiple CRM conditions significantly increased from 5.3% (1999-2002) to 8.0% (2015-2020), with all three conditions rising from 0.7% to 1.5%.
Conclusions:
- CRM multimorbidity is increasingly prevalent and undertreated in the US adult population.
- Higher comorbidity burden is associated with older age, male sex, and specific racial/ethnic and socioeconomic factors.
- Highlights the critical need for collaborative and comprehensive management strategies for CRM conditions.
Importance:
Individually, cardiac, renal, and metabolic (CRM) conditions are common and leading causes of death, disability, and health care-associated costs. However, the frequency with which CRM conditions coexist has not been comprehensively characterized to date.
Objective:
To examine the prevalence and overlap of CRM conditions among US adults currently and over time.
Design, Setting, And Participants:
To establish prevalence of CRM conditions, nationally representative, serial cross-sectional data included in the January 2015 through March 2020 National Health and Nutrition Examination Survey (NHANES) were evaluated in this cohort study. To assess temporal trends in CRM overlap, NHANES data between 1999-2002 and 2015-2020 were compared. Data on 11 607 nonpregnant US adults (≥20 years) were included. Data analysis occurred between November 10, 2020, and November 23, 2022.
Main Outcomes And Measures:
Proportion of participants with CRM conditions, overall and stratified by age, defined as cardiovascular disease (CVD), chronic kidney disease (CKD), type 2 diabetes (T2D), or all 3.
Results:
From 2015 through March 2020, of 11 607 US adults included in the analysis (mean [SE] age, 48.5 [0.4] years; 51.0% women), 26.3% had at least 1 CRM condition, 8.0% had at least 2 CRM conditions, and 1.5% had 3 CRM conditions. Overall, CKD plus T2D was the most common CRM dyad (3.2%), followed by CVD plus T2D (1.7%) and CVD plus CKD (1.6%). Participants with higher CRM comorbidity burden were more likely to be older and male. Among participants aged 65 years or older, 33.6% had 1 CRM condition, 17.1% had 2 CRM conditions, and 5.0% had 3 CRM conditions. Within this subset, CKD plus T2D (7.3%) was most common, followed by CVD plus CKD (6.0%) and CVD plus T2D (3.8%). The CRM comorbidity burden was disproportionately high among participants reporting non-Hispanic Black race or ethnicity, unemployment, low socioeconomic status, and no high school degree. Among participants with 3 CRM conditions, nearly one-third (30.5%) did not report statin use, and only 4.8% and 3.0% used glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, respectively. Between 1999 and 2020, the proportion of US adults with multiple CRM conditions increased significantly (from 5.3% to 8.0%; P < .001 for trend), as did the proportion having all 3 CRM conditions (0.7% to 1.5%; P < .001 for trend).
Conclusions And Relevance:
This cohort study found that CRM multimorbidity is increasingly common and undertreated among US adults, highlighting the importance of collaborative and comprehensive management strategies.
More Related Videos
07:52A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy
Published on: November 7, 2017
09:40Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle
Published on: January 19, 2017
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:30Coronary Artery Disease I: Introduction
01:08Prevalence and Incidence
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:30Coronary Artery Disease III: Clinical Manifestations