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Epidemiology of cardiometabolic multiple long-term conditions

Kamlesh Khunti1, Francesco Zaccardi1, Roopa Mehta2

  • 1Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK; Leicester Real World Evidence Unit, University of Leicester, Leicester, UK.

Lancet (London, England)
|June 8, 2026
PubMed

Insights

Cardiometabolic multiple long-term conditions (MLTC) are common and increase with age, affecting younger adults too. Standardizing definitions is crucial for research and clinical practice.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology
  • Public Health

Background:

  • Cardiometabolic multiple long-term conditions (MLTC), the co-occurrence of diseases like diabetes, cardiovascular disease, and chronic kidney disease, are a growing global health challenge.
  • Current research is hindered by inconsistent definitions, measurements, and analytical methods, limiting study comparability and clinical application.
  • Prevalence varies significantly across populations due to differing study designs and included conditions.

Purpose of the Study:

  • To highlight the increasing prevalence and complexity of cardiometabolic MLTC.
  • To identify limitations in current research and clinical practice regarding cardiometabolic MLTC.
  • To advocate for standardized definitions and improved analytical approaches for cardiometabolic MLTC.

Main Methods:

  • Review of existing literature on cardiometabolic MLTC prevalence, risk factors, and trajectories.
  • Analysis of factors influencing disease accumulation and transitions in cardiometabolic MLTC.
  • Identification of research gaps and challenges in understanding and managing cardiometabolic MLTC.

Main Results:

  • Cardiometabolic MLTC prevalence rises with age but also affects younger adults, especially disadvantaged and minority ethnic groups.
  • Disease accumulation and accelerated transitions post-initial diagnosis lead to premature mortality.
  • Interacting genetic, metabolic, behavioral, psychosocial factors, and socioeconomic inequities shape disease trajectories.

Conclusions:

  • Harmonized definitions, longitudinal data, and advanced analytical methods are essential for advancing cardiometabolic MLTC research.
  • Standardizing the definition of cardiometabolic MLTC is critical for consistency and comparability in research and practice.
  • Addressing socioeconomic and structural inequities is vital to mitigate risk and early onset of cardiometabolic MLTC.

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