Jul 11, 2018 - Prof. Gita Mishra, Prof. Annette Dobson, and Dr. Mark Jones. Centre for Longitudinal and Life Course Research. School of Public Health.
Longitudinal progression of cardiometabolic multimorbidity in mid-aged women: a 20-year cohort study
Xiaolin Xu MMed, MBBS, PhD candidate Co-authors
Prof. Gita Mishra, Prof. Annette Dobson, and Dr. Mark Jones Centre for Longitudinal and Life Course Research School of Public Health The University of Queensland
What is cardiometabolic multimorbidity? the coexistence of diabetes, heart disease, and stroke in a given individual
Diabetes
Heart disease (CHD)
Stroke
• Cardio-MM is the most important multimorbidity experienced by patients and encountered by physicians. • These conditions may interact with each other, and be driven by some come risk factors through the life course. 1. The Emerging Risk Factors Collaboration. Association of Cardiometabolic Multimorbidity With Mortality. JAMA. 2015;314(1):52-60.
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Research question and aims
How these conditions progress from one to another?
• To investigate the progression of cardio-MM in mid-aged women • To determine the roles of common risk factors in the accumulation of cardio-MM.
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Study design
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Cumulative incidence of single condition Diabetes Heart disease
Stroke
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Three conditions were associated with each other
• 2511 (18.3% ) women progressed to at least one condition, 17% (554) had multimorbidity. 7/11/2018
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Cumulative incidence of MM(%)
Longitudinal progression of cardiometabolic MM over 20 years
Diabetes
Years since diagnosis of diabetes
Heart disease
Years since diagnosis of heart disease
Stroke
Years since diagnosis of stroke
• Stroke may accelerate the progression to multimorbidity. 7/11/2018
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Risk factors for accumulation of one cardiometabolic condition and MM
Multimrobidity
Individual condition 0 condition
• Developing two or three conditions wad approximately twice that of developing one condition. 7/11/2018
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Risk factors for accumulation of one cardiometabolic condition and MM
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Risk factors for accumulation of one cardiometabolic condition and MM
• Prior chronic conditions were associated with cardio-MM. 7/11/2018
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Conclusions and implications • The risk of progressing to cardio-MM is much higher than progressing to any single condition • Stroke can accelerate this progression • Social inequality, overweight and obesity, hypertension, physical inactive, current smoker, and having prior chronic conditions are associated with the accumulation of cardio-MM
• Delineation of the disease progression may assist in the evaluation of risk for additional conditions • Identified risk factors are appropriate targets for reducing the risk of cardio-MM
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THANK YOU! The most common chronic condition experienced by adults is multimorbidity. --JAMA Designing Health Care for the Most Common Chronic Condition—Multimorbidity
