During this study, John Danesh, F.Med.Sci., of the University of Cambridge, England, and colleagues estimated reductions in life expectancy associated with cardiometabolic multimorbidity. Age- and sex-adjusted mortality rates and hazard ratios (HR) 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 hazard ratios from this study population were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7,995 deaths).
Primary findings of the study include:
- Participants who had one condition had about twice the rate of death; two conditions about four times the rate of death and three conditions about eight times the rate of death. “Our results emphasise the importance of measures to prevent cardiovascular disease in people who already have diabetes, and, conversely, to avert diabetes in people who already have cardiovascular disease,” the authors write.
- Reductions in life expectancy associated with cardiometabolic multimorbidity are of similar magnitude to those previously noted for exposures of major concern to public health, such as lifelong smoking (10 years of reduced life expectancy) and infection with the human immunodeficiency virus (11 years of reduced life expectancy).
- Modification by sex of associations between cardiometabolic multimorbidity and mortality were noted during the study. For men, the association between baseline cardiovascular disease and reduced survival was stronger than for women, while the association between baseline diabetes and reduced survival was stronger for women. Approximately 60 percent of the years of life lost from cardiometabolic multimorbidity can be attributed to cardiovascular deaths for men compared with only about 45 percent for women.