Epidemiology of cardiometabolic multiple long-term conditions

Cardiometabolic multiple long-term conditions (MLTC), defined as the coexistence of two or more cardiometabolic diseases such as diabetes, cardiovascular disease, and chronic kidney disease, are increasingly prevalent and represent a growing challenge for health systems worldwide. Despite rising interest, progress in understanding cardiometabolic MLTC has been limited by substantial heterogeneity in definitions, measurements, and analytical approaches, restricting comparability across studies and limiting translation into clinical and public health practice. Reported prevalence estimates vary across populations, largely reflecting differences in study design and conditions included. The prevalence of cardiometabolic MLTC increases with age but is not confined to older populations, with these conditions often emerging in early adulthood, particularly among socioeconomically disadvantaged and minority ethnic populations, for whom these conditions also progress more rapidly. Longitudinal studies demonstrate disease accumulation and accelerating transitions following development of a cardiometabolic condition leading to premature mortality. These trajectories are shaped by interacting genetic, metabolic, behavioural, and psychosocial factors, while deprivation and structural inequities substantially amplify risk and earlier onset. Advancing research and improving care will require harmonised definitions, greater use of longitudinal data, and scalable analytical approaches that explicitly capture disease sequencing and transitions. To improve consistency and comparability, the definition of cardiometabolic MLTC should be standardised.