Nearly 1 in 10 U.S. Adults Have Multiple Chronic Conditions Such as Diabetes, Heart Disease

ISLAMABAD, SEP 28 (ONLINE): A new study found that the number of Americans with multiple cardiac, renal, and metabolic conditions is rising.
Approximately one in four adults have a cardiac, renal, or metabolic conditions condition and nearly 1 in 10 have multiple cardiac, renal, or metabolic conditions, according to the reportTrusted Source, which published in JAMA Cardiology on September 27.

The risk of also increased with age—one in three adults 65 and older had a cardiac, renal, or metabolic condition, while almost 1 in 4 had overlapping conditions.
These conditions are the leading cause of morbidity and mortality in the

United States and are estimated to account for every 1 in 3 deaths, according to studyTrusted Source authors.
We have medications to treat the underlying mechanisms that contribute to co-existing cardiac, renal, and metabolic (CRM) conditions; however, they aren’t being prescribed or taken nearly as frequently as they should be.
The new report sheds light on how significantly the incidence of these conditions has grown over the past two decades along with the urgent need to address the situation.

“The findings are doubly concerning as they demonstrate both an increase in the prevalence of cardiac, renal, and metabolic disease and concurrent high levels of undertreatment,” Dr. Dmitriy Nevelev, Associate Director of Cardiology at Staten Island University Hospital, told Healthline. Nevelev wasn’t involved in the study.

Chronic conditions have become much more common since 1999
To determine the prevalence of CRM conditions in the U.S., the researchers evaluated health data from January 2015 through March 2020 sourced from the National Health and Nutrition Examination Survey (NHANES).Trusted Source
They compared those trends against NHANES health data collected between 1999 and 2002.

The analysis included 11,607 non-pregnant adults aged 20 and over.
Of the data pooled from 2015 to 2020, 26.3% had at least 1 CRM condition, 8% had at least two, and 1.5% had three CRM conditions.
The most common comorbid conditions were type 2 diabetes plus chronic kidney disease (3.2%), followed by cardiovascular disease plus type 2 diabetes (1.7%) and cardiovascular disease plus chronic kidney disease (1.6%).

The burden was greatest among non-hispanic Black individuals along with people who reported they were unemployed, of low socioeconomic status, or had no high school degree.
“Disparities in access to healthcare services can result in delayed diagnosis and treatment of cardiac, renal, and metabolic conditions, leading to worse outcomes,” said Dr. David Cutler, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA. Cutler was not involved in the study.

Of those with three CRM conditions, roughly one-third (30.5%) did not report statin use, only 4.8% used medication common for weight loss and diabetes called glucagon-like peptide-1 receptor agonists (GLP1 agonists.) Additionally only 3% took medication commonly used to treat high blood sugar called sodium-glucose cotransporter 2 inhibitors (SGLT2Trusted Source). Trusted Source

“Newer medications like GLP1 agonists — for example, semaglutide — and SGLT2 inhibitors which have been found to improve these conditions are very expensive and were found to be prescribed at a very low rate in this study,” says Cutler.
The proportion of U.S. adults with multiple CRM conditions has grown significantly over the past few decades — from 5.3% in 1999 to 8% in 2020.
The proportion of Americans with three CRM conditions also grew, from 0.7% in 1999 to 1.5% in 2020.

How to combat the rising prevalence of multiple CRM conditions
Research shows that heart, kidney, and metabolic functions are intertwined and share the same risk factors, including obesity, hypertension, blood sugar that is too high or low, and cholesterol imbalance.
Diet and lack of physical activity can contribute to metabolic disorders and obesity, says Cutler.

Genetics, age, and access to healthcare play a role, too.
In addition, stress can affect health behaviors and contribute to the development of these conditions, he added.
The report says that issues with one body system may lead to dysfunction of others and the development of multiple morbidities.

“Fortunately, we can use the common link between these conditions to personalize treatment and prevent their onset,” says Nevelev.
There are drugs that target the underlying pathways involved in the development of comorbidities, such a SGLT2 inhibitors, and may help lower the prevalence of multiple conditions, however, they are being prescribed at a low rate.

“Several factors are at play, including insurance coverage and the associated insurance authorizations burden, overall cost to the patient, prescriber comfort in using newer medications, fear of medication side effects, and in the case of GLP-1 antagonists – availability,” says Nevelev.

The rising prevalence of multiple conditions are expected to accelerate due to the COVID-19 pandemic.
“We now have good data demonstrating pandemic-related decreases in physical activity and increases in sedentary activity and weight gain,” he said.

The findings highlight the need to improve the situation and promote public health efforts, such as promoting healthy lifestyles, improving access to healthcare, and raising awareness about risk factors and early detection.
“We have the tools to lower rates of these diseases. We have to make better use of them,” says Cutler.