They calculated the life expectancy reductions associated with a history of cardiometabolic diseases combining diabetes, strokes and heart attacks.
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Commenting on the study, Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that “prior studies have demonstrated that the greater the number of co-morbid conditions present, the higher the risk of mortality”.
In other words, patients with a history of diabetes, stroke, and Michigan had about 8 times the rate of death compared with those who had no history of any of those 3 conditions. Their results are published today in JAMA (The Journal of the American Medical Association).
“Our results highlight the need to balance the primary and secondary prevention of cardiovascular disease”, the authors of the study wrote.
“However, few population cohorts have had sufficient power, detail and longevity to enable such comparisons”, they add. “We aimed to provide reliable estimates of the associations of cardiometabolic multimorbidity with mortality and reductions in life expectancy”.
For women aged 60, the corresponding estimates were 13 years and 16 years of reduced life expectancy.
Professor Jeremy Pearson, associate medical director at the BHF, said: “Once someone has developed diabetes, or suffered a stroke or heart attack, it is… essential to address all their risk factors, such as their diet and the amount of physical activity they do, to lower their risk of a subsequent heart attack or stroke and give them the best chance of a longer life”. And having all three bumps up premature death risk eightfold, the study found.
Again, these risks multiplied when diseases were added together. For women at the same age, the corresponding estimate was 20 years.
Di Angelantonio also said an individual in their sixties who has both conditions has an average reduction in life expectancy of about 15 years.
Of the participants, 3.6% had a history of diabetes at baseline; 1.2% had experienced a stroke, and 3.1% had an Michigan.
Modification by sex of associations between cardiometabolic multimorbidity and mortality were noted. “Nevertheless, for both men and women, our findings indicate that associations of cardiometabolic multimorbidity extend beyond cardiovascular mortality”. The hazard ratios from this study population were compared with those from the United Kingdom Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7,995 deaths). “Future work will seek to elucidate explanations for these interactions by sex”.
The results suggest that estimated 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).
To explore how such a condition affects death rates, investigators reviewed information on nearly 1.2 million men and women from a number of different countries.
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A report looking into peoples’ lifespans has been funded by the Medical Research Council, the British Heart Foundation, the National Institute of Health Research Cambridge Biomedical Resource Centre and the European Research Council.
