Allostatic load and progression of cardio-renal multimorbidity: A UK biobank study

Area of Science:

• Cardiovascular and Renal Medicine
• Physiology
• Public Health

Background:

• Cardio-renal multimorbidity (CRM), the co-occurrence of cardiovascular disease (CVD) and chronic kidney disease (CKD), presents a substantial public health challenge.
• Allostatic load (AL), reflecting cumulative physiological strain from chronic stress, is a potential modifiable risk factor for CRM.

Purpose of the Study:

• To investigate the association between allostatic load (AL) and the development and progression of cardio-renal multimorbidity (CRM).
• To examine the impact of AL on transitions between health, cardio-renal diseases, and mortality.

Main Methods:

• Analysis of data from 396,927 participants with a median follow-up of 13.67 years.
• Assessment of AL using 10 biomarkers.
• Application of multistate models to analyze health transitions to first cardio-renal disease (FCRD), CRM, and death.

Main Results:

• Elevated AL levels were significantly linked to increased risks of progressing from health to FCRD, CRM, and mortality.
• The transition from FCRD to CRM was notably influenced by high AL.
• AL showed a stronger association with the progression to CKD than to CVD.
• Associations were more pronounced in younger individuals, those with higher socioeconomic status, and those with unhealthy diets.

Conclusions:

• Allostatic load (AL) is a critical upstream determinant in the development and progression of CRM.
• Early identification of individuals with high AL is crucial for effective risk stratification and the implementation of preventative measures against CRM.