Association of age at cardiometabolic disease diagnosis with mortality and life expectancy: 8.4 million person-years of observation.
Cardiometabolic disease (CMD) and cardiometabolic multimorbidity (CMM) are increasing rapidly, particularly among younger adults. This study aimed to quantify associations of age at CMD/CMM diagnosis with mortality risk and life expectancy.
A total of 684,218 participants from six cohorts (UK Biobank, US NHANES, SHARE, CHARLS, CMEC, and ELSA) were included. CMD was defined as the presence of cardiovascular disease (CVD), hypertension, or diabetes. Cox proportional hazard models were used to estimate hazard ratios (HRs) for all-cause and cause-specific mortality according to age at CMD diagnosis. Life expectancy reduction were further evaluated by age of diagnosis.
Earlier CMD diagnosis showed a clear dose-response association with higher mortality across cohorts. In the UK Biobank, the HR (95% CI) for all-cause mortality was 5.91 (4.95-7.06) for diagnosis before age 40, declining to 1.37 (1.33-1.41) at ≥70 years. Similar trends were observed in other cohorts. Earlier CMD diagnosis were also associated with greater life expectancy reduction. For instance, among 60-year-olds in the UK Biobank, those diagnosed before age 40, at 40-49, and at 50-59 years lost approximately 9.3, 5.4, and 3.2 years, respectively. For multimorbidity, mortality risk and years of life lost increased with the number of CMDs. Participants with coexisting CVD and hypertension diagnosed before age 40 had the highest mortality risk [7.36 (5.09-10.63)] and lost about 9.6 years of life at age 60.
Earlier diagnosis of CMD and CMM is strongly associated with elevated mortality and substantial reductions in life expectancy. These findings underscore the importance of early preventive intervention strategies to delay disease onset and mitigate premature mortality.
A total of 684,218 participants from six cohorts (UK Biobank, US NHANES, SHARE, CHARLS, CMEC, and ELSA) were included. CMD was defined as the presence of cardiovascular disease (CVD), hypertension, or diabetes. Cox proportional hazard models were used to estimate hazard ratios (HRs) for all-cause and cause-specific mortality according to age at CMD diagnosis. Life expectancy reduction were further evaluated by age of diagnosis.
Earlier CMD diagnosis showed a clear dose-response association with higher mortality across cohorts. In the UK Biobank, the HR (95% CI) for all-cause mortality was 5.91 (4.95-7.06) for diagnosis before age 40, declining to 1.37 (1.33-1.41) at ≥70 years. Similar trends were observed in other cohorts. Earlier CMD diagnosis were also associated with greater life expectancy reduction. For instance, among 60-year-olds in the UK Biobank, those diagnosed before age 40, at 40-49, and at 50-59 years lost approximately 9.3, 5.4, and 3.2 years, respectively. For multimorbidity, mortality risk and years of life lost increased with the number of CMDs. Participants with coexisting CVD and hypertension diagnosed before age 40 had the highest mortality risk [7.36 (5.09-10.63)] and lost about 9.6 years of life at age 60.
Earlier diagnosis of CMD and CMM is strongly associated with elevated mortality and substantial reductions in life expectancy. These findings underscore the importance of early preventive intervention strategies to delay disease onset and mitigate premature mortality.
Authors
Wang Wang, Long Long, Liu Liu, Zhang Zhang, Li Li, Shen Shen, Wang Wang, Liu Liu, Liu Liu, Zhang Zhang, Chen Chen, Qu Qu, Huang Huang, Tang Tang, Zhong Zhong
View on Pubmed