Chronic Ills May Add Up to a Shortened Life Span

Study finds combination of diabetes, heart disease and stroke can cut up to 15 years of life expectancy

Tuesday, July 7, 2015

TUESDAY, July 7, 2015 (HealthDay News) -- While having one major health problem -- such as diabetes, heart disease or stroke -- can increase your risk for an early death, new research warns that the risk of dying prematurely goes up significantly if you have more than one of these conditions.

Investigators determined that someone with one of those conditions faces double the risk of early death compared to people who have no such "cardiometabolic" problems. But, those coping with two conditions at the same time were found to face quadruple the risk. And having all three bumps up premature death risk eightfold, the study found.

"Somewhat surprised" is how study lead author Dr. Emanuele Di Angelantonio, a university lecturer in medical screening with the department of public health and primary care at the University of Cambridge in England, described his team's reaction to the findings.

Di Angelantonio explained that the three conditions actually share many risk factors in common, such as high blood pressure, high cholesterol, high blood sugar and obesity. And given that "previous research has mainly focused on individuals with one cardiometabolic condition alone," the magnitude associated with combined risk was not necessarily evident.

This is the first study that is able to precisely quantify how much worse it is to have more than one of these diseases, he pointed out.

Di Angelantonio and his colleagues reported their findings in the July 7 issue of the Journal of the American Medical Association.

The study authors pointed out that about 10 million men and women have some combination of diabetes, heart disease and stroke history in the United States and Europe. Recent estimates, the study authors noted, suggest about 3 percent of the American public has such a multiple risk profile.

To explore how such a condition affects death rates, investigators reviewed information on almost 1.2 million men and women from a number of different countries.

The research team concluded that the years of life lost associated with having two or three of the target diseases ended up being even greater than the years lost in life expectancy among lifelong smokers and HIV patients.

Smokers and people with HIV have been found to lose about 10 to 11 years of life expectancy, the study authors said. By comparison, having two cardiometabolic risk conditions at age 60 was linked to a 12-year drop in life expectancy, while having three conditions was linked to a 15-year drop, the researchers said. And those numbers could go even higher among patients whose diseases first strike before the age of 40, they added.

These findings are mainly for use by clinicians and policymakers, noted Di Angelantonio. The study results "emphasize, for example, the importance of measures to prevent cardiovascular disease in people who already have diabetes, and, conversely, to avert diabetes in people who already have cardiovascular disease," he said.

"At the same time, we must not lose sight of tackling these serious conditions [one-by-one] within the wider population," Di Angelantonio added.

Commenting on the study, Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "prior studies have demonstrated that the greater the number of co-morbid conditions present, the higher the risk of mortality." And, in some cases, "that risk increase is more than just additive, but synergistic," he added.

"Having multiple simultaneous diseases present can complicate accurate diagnosis, assessment and treatment in such ways as to increase mortality risk," Fonarow said.

So, "maintaining one's health and avoiding chronic conditions should be a lifelong goal. Being physically active, not smoking and maintaining healthy levels of body weight, blood pressure and cholesterol can help lower the risk of diabetes, cardiovascular disease, stroke and cancer," Fonarow said.

SOURCES: Emanuele Di Angelantonio, M.D., university lecturer in medical screening, department of public health and primary care, University of Cambridge, Cambridge, England; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; July 7, 2015, Journal of the American Medical Association

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