Obesity-related multimorbidity and risk of cardiovascular disease in the middle-aged population in the United States

Lisa M. Pollack, Mei Wang, Man Yee Mallory Leung, Graham Colditz, Cynthia Herrick, Su Hsin Chang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish
Article number106225
JournalPreventive Medicine
Volume139
DOIs
StatePublished - Oct 2020

Keywords

  • Chronic disease
  • Multimorbidity
  • Obesity

Fingerprint

Dive into the research topics of 'Obesity-related multimorbidity and risk of cardiovascular disease in the middle-aged population in the United States'. Together they form a unique fingerprint.

Cite this