Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status

Abstract

Cardiovascular diseases stand as a prominent global cause of mortality, their intricate origins often entwined with comorbidities and multimorbid conditions. Acknowledging the pivotal roles of age, sex, and social determinants of health in shaping the onset and progression of these diseases, our study delves into the nuanced interplay between life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Leveraging data from a cross-sectional survey encompassing Mexican adults, we unearth a robust association between these variables and the prevalence of comorbidities linked to cardiovascular conditions. To foster a comprehensive understanding of multimorbidity patterns across diverse life-stages, we scrutinize an extensive dataset comprising 47,377 cases diagnosed with cardiovascular ailments at Mexico's national reference hospital. Extracting sociodemographic details, primary diagnoses prompting hospitalization, and additional conditions identified through ICD-10 codes, we unveil subtle yet significant associations and discuss pertinent specific cases. Our results underscore a noteworthy trend: younger patients of lower socioeconomic status exhibit a heightened likelihood of cardiovascular comorbidities compared to their older counterparts with a higher socioeconomic status. By empowering clinicians to discern non-evident comorbidities, our study aims to refine therapeutic designs. These findings offer profound insights into the intricate interplay among life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Armed with data-supported approaches that account for these factors, clinical practices stand to be enhanced, and public health policies informed, ultimately advancing the prevention and management of cardiovascular disease in Mexico.

Keywords: cardiovascular diseases; comorbidities; diseasome; health care; human disease network; socioeconomic status.

Figure 1

Flow chart of study. The figure represents the general workflow of this study from data collection (EHR mining), data pre-processing and processing, analytics, results and discussion.

Figure 2

Presence of disease pairs in different stages of life by sex and socioeconomic status.

Figure 3

Comorbidity networks for patients aged 0–20 years old, for both sexes in the low (LSES) and high (HSES) socioeconomic status. Nodes are ordered according with their Page Rank Score (PRS). High PRS nodes appear in the center. Size and color intensity (red implies higher values, blue lower values) of the nodes is also given by the PRS as a measure of relative importance in the network. Size and color of the edges represent the mutual information weight among disease pairs.

Figure 4

Comorbidity networks for patients aged 21–40 years old, for both sexes in the low (LSES) and high (HSES) socioeconomic status. Visualization parameters are as in Figure 3.

Figure 5

Comorbidity networks for patients aged 41–60 years old, for both sexes in the low (LSES) and high (HSES) socioeconomic status. Visualization parameters are as in Figure 3.

Figure 6

Comorbidity networks for patients aged 61–80 years old, for both sexes in the low (LSES) and high (HSES) socioeconomic status. Visualization parameters are as in Figure 3.

Figure 7

Comorbidity networks for patients aged 81 years and older, for both sexes in the low (LSES) and high (HSES) socioeconomic status. Visualization parameters are as in Figure 3.