Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2008 Jul;58(552):488-94.
doi: 10.3399/bjgp08X319459.

Multimorbidity and risk among patients with established cardiovascular disease: a cohort study

Liam G Glynn  1 , Brian Buckley, Donal Reddan, John Newell, John Hinde, Sean F Dinneen, Andrew W Murphy
Affiliations
Multicenter Study

Multimorbidity and risk among patients with established cardiovascular disease: a cohort study

Liam G Glynn et al. Br J Gen Pract. 2008 Jul.

Abstract

Background: Most patients managed in primary care have more than one condition. Multimorbidity presents challenges for the patient and the clinician, not only in terms of the process of care, but also in terms of management and risk assessment.

Aim: To examine the effect of the presence of chronic kidney disease and diabetes on mortality and morbidity among patients with established cardiovascular disease.

Design of study: Retrospective cohort study.

Setting: Random selection of 35 general practices in the west of Ireland.

Method: A practice-based sample of 1609 patients with established cardiovascular disease was generated in 2000-2001 and followed for 5 years. The primary endpoint was death from any cause and the secondary endpoint was a cardiovascular composite endpoint that included death from a cardiovascular cause or any of the following cardiovascular events: myocardial infarction, heart failure, peripheral vascular disease, or stroke.

Results: Risk of death from any cause was significantly increased in patients with increased multimorbidity (P<0.001), as was the risk of the cardiovascular composite endpoint (P<0.001). Patients with cardiovascular disease and diabetes had a similar survival pattern to those with cardiovascular disease and chronic kidney disease, but experienced more cardiovascular events.

Conclusion: Level of multimorbidity is an independent predictor of prognosis among patients with established cardiovascular disease. In such patients, the presence of chronic kidney disease carries a similar mortality risk to diabetes. Multimorbidity may be a useful factor in prioritising management of patients in the community with significant cardiovascular risk.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier survival plots for risk of ‘death from any cause’ according to level of cardiovascular multimorbidity.
Figure 2
Figure 2
Kaplan-Meier survival plots for risk of composite cardiovascular outcome according to level of cardiovascular multimorbidity.
See this image and copyright information in PMC

References

    1. Fortin M, Bravo G, Hudon C, et al. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–228. - PMC - PubMed
    1. Smith SM, O'Dowd T. Chronic diseases: what happens when they come in multiples? Br J Gen Pract. 2007;57(537):268–270. - PMC - PubMed
    1. Fortin M, Lapointe L, Hudon C, et al. Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes. 2004;20(2):51. - PMC - PubMed
    1. Starfield B. Threads and yarns: weaving the tapestry of comorbidity. Ann Fam Med. 2006;4(2):101–103. - PMC - PubMed
    1. Fortin M, Lapointe L, Hudon C, Vanasse A. Multimorbidity is common to family practice: is it commonly researched? Can Fam Physician. 2005;51(2):244–245. - PMC - PubMed

Publication types