Cardiometabolic multimorbidity prevalence and mortality risks in Chinese old-old population: real-world evidence from continuing care retirement community

AIMS: To provide evidence on cardiometabolic multimorbidity (CMM) among very elderly Chinese. METHODS: This was a retrospective analysis of Chinese elderly in Taikang Community. Cardiometabolic disease hypertension, diabetes, coronary artery disease (CHD), stroke, and heart failure (HF) prevalence and CMM patterns were presented. A subgroup with follow-up records was further evaluated for the disease management outcomes. The mortality risks of various diseases were assessed using weighted logistic regression. RESULTS: A total of 20,360 older adults (median age 83.3 years) were included. Hypertension (78.8%) was the most prevalent cardiometabolic condition. The overall CMM prevalence was 51.8%, with hypertension-diabetes being the most prevalent pattern (16.5%). During follow-up, the achievement rates for hypertension, diabetes, and CHD management were 54.6%, 70.0%, and 18.1%, respectively. The independent mortality risk of the diseases was HF, CHD, stroke, diabetes, and hypertension in descending order. Diabetes as a comorbidity of hypertension had minimal influence on the mortality risk. CONCLUSIONS: Among Chinese old-old population, hypertension was the most prevalent cardiometabolic condition, with hypertension-diabetes being the most prevalent CMM pattern. Uncomplicated hypertension or diabetes without organ damage was associated with limited increase in mortality risk when well-managed, whereas HF as the greatest risk factor warrant more proactive follow-up interventions.