Abstract: TH-PO601
Prevalence and Overlap of Cardio-Renal-Metabolic Conditions in US Adults, 2015-2018
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Ostrominski, John W., Brigham and Women's Hospital Carl J and Ruth Shapiro Cardiovascular Center, Boston, Massachusetts, United States
- Arnold, Suzanne V., Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
- Butler, Javed, Baylor Scott & White Health, Dallas, Texas, United States
- Fonarow, Gregg C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
- Hirsch, Jamie S., Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
- Palli, Swetha R., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Parrinello, Christina, Pine Mountain Consulting, Redding, Connecticut, United States
- Collins, Eric B., Medicus Economics, LLC, Philadelphia, Pennsylvania, United States
- O'Connell, Tom, Medicus Economics, LLC, Boston, Massachusetts, United States
- Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
- Vaduganathan, Muthiah, Brigham and Women's Hospital Carl J and Ruth Shapiro Cardiovascular Center, Boston, Massachusetts, United States
Background
Cardio-renal-metabolic (CRM) conditions are leading causes of death, disability, and economic burden. Individually, CRM conditions are prevalent in the US population, but the frequency with which CRM conditions coexist has not been comprehensively characterized.
Methods
Nationally representative, cross-sectional data on nonpregnant US adults aged ≥20 years from the 2015-2018 NHANES were evaluated. We calculated the proportion of participants with CRM conditions - overall and stratified by age - defined as cardiovascular disease (CVD; atherosclerotic CVD or heart failure), chronic kidney disease (CKD), or type 2 diabetes (T2D). CRM risk factors were also examined by CRM status.
Results
Of 9113 US adults included in the analysis (mean age 48.3 y [SD 0.44]; 51.0% women), 27.6% (~70 million adults using population weights) had ≥1 CRM condition, 8.7% had ≥2 CRM conditions, and 1.5% had all 3 CRM conditions (Figure). Individually, CVD was observed in 10.1% of participants, CKD in 14.7%, and T2D in 13.1%. CKD+T2D was the most common CRM dyad (3.2%), followed by CVD+CKD (2.1%) and CVD+T2D (1.9%). Among participants aged ≥65 years, 59.1% had ≥1 CRM condition, 24.5% had ≥2, and 4.9% had 3 CRM conditions. In this group, CVD+CKD (8.2%) was most common, followed by CKD+T2D (7.4%) and CVD+T2D (4.0%). Higher CRM comorbidity burden was associated with more severe CKD stage, additive CVD conditions, older age, male sex, Black race, greater prevalence of key CRM risk factors, and adverse socioeconomic characteristics. Among those with all 3 CRM conditions, 67%, 64%, 4%, and 3% of participants were on a statin, ACEi/ARB, GLP1-RA, or SGLT2i, respectively.
Conclusion
CRM conditions commonly intersect in the contemporary US population, with more than a quarter having ≥1 CRM condition. Use of disease-modifying evidence-based CRM therapies remains suboptimal.