What midlife factors drive cardiometabolic multimorbidity?
In 8,270 Whitehall II adults followed ~24 years, clinical risk at 50 best predicted first cardiometabolic disease, while socioeconomic and behavioural factors better predicted progression to multimorbidity and death.
Source
Clinical, socioeconomic, and behavioural factors at age 50 years and risk of cardiometabolic multimorbidity and mortality: A cohort study
What they did
Assessed clinical, socioeconomic, and behavioural risk scales at age 50 in the Whitehall II cohort and modelled transitions from healthy → first cardiometabolic disease → multimorbidity → death over mean 23.7 years.
What they found
2,501 developed one cardiometabolic disease, 511 multimorbidity, and 1,406 died. Least vs most favourable clinical profile predicted first disease (HR 3.74). Socioeconomic and behavioural factors predicted multimorbidity progression; only behavioural factors predicted mortality after disease.
The limits
What it doesn't show
Observational Whitehall II data cannot prove causality; findings are midlife risk scales in UK civil servants and may not generalize to all populations or non-cardiometabolic multimorbidity.
Key terms
- Cardiometabolic multimorbidity
- At least 2 of diabetes, coronary heart disease, and stroke in the same person.
- Whitehall II
- Longitudinal UK civil-servant cohort used here with decades of follow-up.
- Clinical profile
- Midlife hypertension, hypercholesterolemia, overweight/obesity, and family history scored together.
- Occupational position
- Socioeconomic marker used as one of three midlife risk scales.
- Behavioural factors
- Smoking, alcohol, diet, and physical activity scored at age 50.
- Hazard ratio
- Relative instantaneous risk comparing least vs most favourable midlife profiles.
Flashcards
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Whitehall II analytic N was about:
Common questions
How large was the cohort?
8,270 men and women with mean 23.7 years of follow-up.
How was multimorbidity defined?
At least 2 of diabetes, coronary heart disease, and stroke.
What best predicted first disease?
Midlife clinical profile (HR 3.74 for least vs most favourable).
What predicted death after disease?
Only midlife behavioural factors (e.g., HR 3.47 with multimorbidity).