TY - JOUR
T1 - Obesity-related multimorbidity and risk of cardiovascular disease in the middle-aged population in the United States
AU - Pollack, Lisa M.
AU - Wang, Mei
AU - Leung, Man Yee Mallory
AU - Colditz, Graham
AU - Herrick, Cynthia
AU - Chang, Su Hsin
N1 - Funding Information:
The research presented in this paper is that of the authors and does not reflect the official policy of the NIH. The Foundation for Barnes-Jewish Hospital supported this research. LM Pollack was supported by T32CA190194. S-H Chang was supported by NIH Grants U54CA155496, R21DK110530 and AHRQ Grant K01HS022330. CJH is supported by NIH grant 1K23 HD096204-01A1.
Funding Information:
The research presented in this paper is that of the authors and does not reflect the official policy of the NIH. The Foundation for Barnes-Jewish Hospital supported this research. LM Pollack was supported by T32CA190194. S-H Chang was supported by NIH Grants U54CA155496 , R21DK110530 and AHRQ Grant K01HS022330 . CJH is supported by NIH grant 1K23 HD096204-01A1 .
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - To investigate the prevalence of obesity-related multimorbidity (co-occurrence of ≥2 obesity-related chronic diseases, ORCDs) and the risk of cardiovascular disease in the presence of multimorbidity in middle-aged adults in the United States. National Health and Nutrition Examination Survey data from 2007 to 2016 were used. Target ORCDs included hypertension (H), diabetes (D), coronary heart disease (C), and stroke (S). Age-standardized prevalence for obesity-related multimorbidity in its combination and permutation was calculated. Risk for cardiovascular disease (C or S) was estimated conditional on demographics, degree of obesity, and presence and duration of pre-existing ORCDs. Analyses were conducted at Washington University in 2019. The analytic sample included 14,243 individuals age 40–79 years, representing a population size of 110,003,550. Age-standardized prevalence for obesity-related multimorbidity was 12.3%. Hypertension was most commonly the first diagnosed ORCD for populations with 2–4 ORCDs, followed by diabetes for populations with 2–3 ORCDs. Compared with no pre-existing hypertension/diabetes/stroke, pre-existing hypertension in combination with diabetes/stroke significantly increased risk of coronary heart disease [H + S (multivariable-adjusted hazard ratio, aHR 27.6, 95% CI 10.9–70.2), D + H + S (aHR 20.3, 95% CI 7.9–52.2)]. Compared with no hypertension/diabetes/coronary heart disease, pre-existing hypertension in combination with diabetes/coronary heart disease significantly increased risk of stroke [C + D + H (aHR 32.6, 95% CI 12.2–87.1), C + H (aHR 25.4, 95% CI 12.1–53.6), D + H (aHR 5.3, 95% CI 2.6–10.8)]. Obesity-related multimorbidity is prevalent and highly associated with cardiovascular disease development. To reduce the detrimental health impact of multimorbidity, intervention strategies should target preventing increasing multimorbidity and detecting/managing diabetes and hypertension prior to the onset of cardiovascular disease.
AB - To investigate the prevalence of obesity-related multimorbidity (co-occurrence of ≥2 obesity-related chronic diseases, ORCDs) and the risk of cardiovascular disease in the presence of multimorbidity in middle-aged adults in the United States. National Health and Nutrition Examination Survey data from 2007 to 2016 were used. Target ORCDs included hypertension (H), diabetes (D), coronary heart disease (C), and stroke (S). Age-standardized prevalence for obesity-related multimorbidity in its combination and permutation was calculated. Risk for cardiovascular disease (C or S) was estimated conditional on demographics, degree of obesity, and presence and duration of pre-existing ORCDs. Analyses were conducted at Washington University in 2019. The analytic sample included 14,243 individuals age 40–79 years, representing a population size of 110,003,550. Age-standardized prevalence for obesity-related multimorbidity was 12.3%. Hypertension was most commonly the first diagnosed ORCD for populations with 2–4 ORCDs, followed by diabetes for populations with 2–3 ORCDs. Compared with no pre-existing hypertension/diabetes/stroke, pre-existing hypertension in combination with diabetes/stroke significantly increased risk of coronary heart disease [H + S (multivariable-adjusted hazard ratio, aHR 27.6, 95% CI 10.9–70.2), D + H + S (aHR 20.3, 95% CI 7.9–52.2)]. Compared with no hypertension/diabetes/coronary heart disease, pre-existing hypertension in combination with diabetes/coronary heart disease significantly increased risk of stroke [C + D + H (aHR 32.6, 95% CI 12.2–87.1), C + H (aHR 25.4, 95% CI 12.1–53.6), D + H (aHR 5.3, 95% CI 2.6–10.8)]. Obesity-related multimorbidity is prevalent and highly associated with cardiovascular disease development. To reduce the detrimental health impact of multimorbidity, intervention strategies should target preventing increasing multimorbidity and detecting/managing diabetes and hypertension prior to the onset of cardiovascular disease.
KW - Chronic disease
KW - Multimorbidity
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85090551433&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2020.106225
DO - 10.1016/j.ypmed.2020.106225
M3 - Article
C2 - 32768511
AN - SCOPUS:85090551433
SN - 0091-7435
VL - 139
JO - Preventive Medicine
JF - Preventive Medicine
M1 - 106225
ER -