Having a combination of diabetes and heart disease reduces an individual’s life expectancy by more than 10 years, according to new research from the University of Cambridge. While there is a great deal of evidence that the presence of a single cardiometabolic illness can reduce life expectancy, there has been little research into the mortality risk associated with having more than one such condition.
The authors reviewed 689 300 participants in the Emerging Risk Factors Collaboration registry and 499 808 from the UK Biobank. At the most recent follow-up in 2013, there had been a total of 136 838 deaths. Compared with people with no history of diabetes, myocardial infarction (MI) or stroke, people with one condition had double the risk of early death, those with two had quadruple the risk and those with all three had an eightfold risk. Around one person in 100 had a history of more than one of these illnesses. When adjusted to the age of 60 years, a history of two conditions reduced life expectancy by 12 years, and a history of all three reduced it by 15 years.
Compared with the reference group of participants with no cardiometabolic disease, mortality rates per 1000 person-years were as follows:
- 15.6 in participants with a history of diabetes (hazard ratio [HR], 1.9).
- 16.1 in those with stroke (HR, 2.1).
- 16.8 in those with MI (HR, 2.0).
- 32.0 in those with diabetes and MI (HR, 3.7).
- 32.5 in those with diabetes and stroke (HR, 3.8).
- 32.8 in those with stroke and MI (HR, 3.5).
- 59.5 in those with diabetes, stroke, and MI (HR, 6.9).
Commenting on the study, Professor John Danesh said: “Our results highlight the importance of preventing heart disease and stroke amongst patients with diabetes, and likewise averting diabetes amongst heart disease patients.”
“Although patients with more than one condition constitute only a small proportion of the population at large, in real terms the numbers are not insignificant. Measures aimed at reducing diabetes and heart disease amongst this group could have a dramatic impact on their lives. However, at the same time, we must not lose sight of tackling these serious conditions within the wider population.”
The study can be read in full here.
