The trajectories of cardiometabolic multimorbidity associate with mortality risk: a study based on Guangdong adult chronic diseases and risk factors cohort

Background: Cardiometabolic multimorbidity (CMM) prevalence has risen, but longitudinal evidence on trajectories and mortality links remains limited. Objective: This study aimed to examine CMM trends and the impact of its statuses/trajectories on mortality in Guangdong, China. Design: This is a cohort study. Setting: Data were collected from the Guangdong Provincial adult chronic diseases and risk factors cohort (GDACRC). The follow-up data were collected from the hospitalization record system and the vital register system in Guangdong Province. Participants: Baseline surveys were separately conducted in 2007, 2010, 2013, 2015, and 2018, which recruited 34,244 participants aged 18 years or older. Measurements: Calculated age-sex standardized CMM prevalence. Cox proportional hazards models were used to assess the associations between CMM statuses/trajectories and mortality risk. Compared with participants without any cardiometabolic diseases (CMD), the mortality risk of those with single CMD and CMM, respectively, increased by 30 and 85%, with a greater risk of patients aged < 65 years. The most common trajectory was from metabolic disease (M) to cardiovascular diseases (C), that 9.31% healthy participants at baseline developed CMM on this trajectory, which accounted for 53.5% of all CMM patients. Compared to patients with single M, patients with the trajectory from C to M had greater mortality risk (HR = 3.32, 95% CI: 2.13-5.16). Limitation: Single-province sample; self-report bias. Conclusion: CMM represents a major public health challenge in Guangdong Province, China. Our findings provide new insights on the CMM progression, which may be helpful for prevention and clinical management of CMM.