Suh, Jae Won;
Floud, Sarah;
Reeves, Gillian K;
Cairns, Benjamin J;
Wright, Frances Lucy;
(2023)
Multimorbidity of cardiovascular disease subtypes in a prospective cohort of 1.2 million UK women.
Open Heart
, 10
(2)
, Article e002552. 10.1136/openhrt-2023-002552.
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Abstract
OBJECTIVE: Cardiovascular multimorbidity (CVM) is the co-occurrence of multiple cardiovascular disease subtypes (CVDs) in one person. Because common patterns and incidence of CVM are not well-described, particularly in women, we conducted a descriptive study of CVM in the Million Women Study, a large population-based cohort of women. METHODS: UK women aged 50-64 years were followed up using hospital admissions and mortality records for an average of 19 years. CVM was defined as having ≥2 of 19 selected CVDs. The age-specific cumulative incidence of CVM between age 60 and 80 years was estimated. The numbers and proportions of individual, pairs and other combinations of CVDs that comprised incident CVM were calculated. For each individual CVD subtype, age-standardised proportions of the counts of other co-occurring CVDs were estimated. RESULTS: The age-specific likelihood of having CVM nearly doubled every 5 years between age 60 and 80 years. Among 1.2 million women without CVD at study baseline, 16% (n=196 651) had incident CVM by the end of follow-up. Around half of all women with CVM had a diagnosis of ischaemic heart disease (n=102 536) or atrial fibrillation (n=96 022), almost a third had heart failure (n=72 186) and a fifth had stroke (n=40 442). The pair of CVDs with the highest age-adjusted incidence was ischaemic heart disease and atrial fibrillation (18.95 per 10 000 person-years). Over 60% of individuals with any given CVD subtype also had other CVDs, after age standardisation. CONCLUSIONS: CVM is common. The majority of women with any specific CVD subtype eventually develop at least one other. Clinical and public health guidelines for CVD management should acknowledge this high likelihood of CVM.
| Type: | Article |
|---|---|
| Title: | Multimorbidity of cardiovascular disease subtypes in a prospective cohort of 1.2 million UK women |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/openhrt-2023-002552 |
| Publisher version: | http://dx.doi.org/10.1136/openhrt-2023-002552 |
| Language: | English |
| Additional information: | This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Arrhythmias, cardiac, coronary artery disease, electronic health records, epidemiology, stroke, Humans, Female, Cardiovascular Diseases, Atrial Fibrillation, Prospective Studies, Multimorbidity, Risk Factors, Myocardial Ischemia, United Kingdom |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184575 |
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