Association of cardiometabolic multimorbidity with all-cause and cardiovascular disease mortality among Chinese hypert-ensive patientsOA北大核心

BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabo-lic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate the association betw-een CMM and all-cause and cardiovascular disease(CVD)mortality in Chinese patients with hypertension. METHODS The data used in this study were from the China National Survey for Determinants of Detection and Treatment Sta-tus of Hypertensive Patients with Multiple Risk Factors(CONSIDER),which comprised 5006 participants aged 19-91 years.CMM was defined as the presence of one or more of the following morbidities:diabetes mellitus,dyslipidemia,chronic kidney disease,coronary heart disease,and stroke.Cox proportional hazard models were used to calculate the hazard ratios(HR)with 95%CI to determine the association between the number of CMMs and both all-cause and CVD mortality. RESULTS Among 5006 participants[mean age:58.6±10.4 years,50%women(2509 participants)],76.4%of participants had at least one comorbidity.The mortality rate was 4.57,4.76,8.48,and 16.04 deaths per 1000 person-years in hypertensive patients wit-hout any comorbidity and with one,two,and three or more morbidities,respectively.In the fully adjusted model,hypertensive participants with two cardiometabolic diseases(HR = 1.52,95%CI:1.09-2.13)and those with three or more cardiometabolic disea-ses(HR = 2.44,95%CI:1.71-3.48)had a significantly elevated risk of all-cause mortality.The findings were similar for CVD mor-tality but with a greater increase in risk magnitude. CONCLUSIONS In this study,three-fourths of hypertensive patients had CMM.Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients,suggest-ing more intensive treatment and control in this high-risk patient group.