Association of cardiometabolic multimorbidity with mortality

Simple item page
dc.contributor.authorEmerging Risk Factors Collaboration,
dc.contributor.authorDi Angelantonio, E.
dc.contributor.authorKaptoge, S.
dc.contributor.authorWormser, D.
dc.contributor.authorWilleit, P.
dc.contributor.authorButterworth, A.
dc.contributor.authorBansal, N.
dc.contributor.authorO'Keeffe, L.
dc.contributor.authorGao, P.
dc.contributor.authorWood, A.
dc.contributor.authorBurgess, S.
dc.contributor.authorFreitag, D.
dc.contributor.authorPennells, L.
dc.contributor.authorPeters, S.
dc.contributor.authorHart, C.
dc.contributor.authorHaheim, L.
dc.contributor.authorGillum, R.
dc.contributor.authorNordestgaard, B.
dc.contributor.authorPsaty, B.
dc.contributor.authorYeap, B.
dc.contributor.authoret al.
dc.date.issued2015
dc.descriptionDeborah Lawlor is an author/member of the Emerging Risk Factors Collaboration
dc.description.abstractIMPORTANCE The prevalence of cardiometabolic multimorbidity is increasing. OBJECTIVE To estimate reductions in life expectancy associated with cardiometabolic multimorbidity. DESIGN, SETTING, AND PARTICIPANTS Age- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689 300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128 843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499 808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates. EXPOSURES A history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI). MAIN OUTCOMES AND MEASURES All-cause mortality and estimated reductions in life expectancy. RESULTS In participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. CONCLUSIONS AND RELEVANCE Mortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.
dc.description.statementofresponsibilityThe Emerging Risk Factors Collaboration
dc.identifier.citationJAMA: Journal of the American Medical Association, 2015; 314(1):52-60
dc.identifier.doi10.1001/jama.2015.7008
dc.identifier.issn0098-7484
dc.identifier.issn1538-3598
dc.identifier.orcidLawlor, D. [0000-0002-6793-2262]
dc.identifier.urihttp://hdl.handle.net/2440/98671
dc.language.isoen
dc.publisherAmerican Medical Association
dc.rightsCopyright 2015 American Medical Association. All rights reserved.
dc.source.urihttps://doi.org/10.1001/jama.2015.7008
dc.subjectEmerging Risk Factors Collaboration
dc.subjectHumans
dc.subjectMyocardial Infarction
dc.subjectDiabetes Mellitus
dc.subjectLife Expectancy
dc.subjectMortality
dc.subjectRisk Factors
dc.subjectComorbidity
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectStroke
dc.titleAssociation of cardiometabolic multimorbidity with mortality
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications