Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium

Background: Studies on the association between multimorbidity and mortality in large populations have mainly been conducted in European and North American populations. This study aimed to identify the association between cardiometabolic multimorbidity and all-cause and cardiovascular disease (CVD) m...

Full description

Saved in:
Bibliographic Details
Main Authors: Sangjun Lee, Choonghyun Ahn, Sarah Krull Abe, Md Shafiur Rahman, Md Rashedul Islam, Eiko Saito, Seokyung An, Norie Sawada, Xiao-Ou Shu, Woon-Puay Koh, Hui Cai, Atsushi Hozawa, Seiki Kanemura, Chisato Nagata, San-Lin You, Daehee Kang, Rieko Kanehara, Yu-Tang Gao, Jian-Min Yuan, Wanqing Wen, Yumi Sugawara, Keiko Wada, Chien-Jen Chen, Keun-Young Yoo, Habibul Ahsan, Kee Seng Chia, Aesun Shin, Jeongseon Kim, Jung Eun Lee, Keitaro Matsuo, Nathaniel Rothman, You-Lin Qiao, Wei Zheng, Paolo Boffetta, Manami Inoue, Sue K. Park
Format: Article
Language:English
Published: Japan Epidemiological Association 2025-07-01
Series:Journal of Epidemiology
Subjects:
Online Access:https://www.jstage.jst.go.jp/article/jea/35/7/35_JE20240362/_pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849709387104387072
author Sangjun Lee
Choonghyun Ahn
Sarah Krull Abe
Md Shafiur Rahman
Md Rashedul Islam
Eiko Saito
Seokyung An
Norie Sawada
Xiao-Ou Shu
Woon-Puay Koh
Hui Cai
Atsushi Hozawa
Seiki Kanemura
Chisato Nagata
San-Lin You
Daehee Kang
Rieko Kanehara
Yu-Tang Gao
Jian-Min Yuan
Wanqing Wen
Yumi Sugawara
Keiko Wada
Chien-Jen Chen
Keun-Young Yoo
Habibul Ahsan
Kee Seng Chia
Aesun Shin
Jeongseon Kim
Jung Eun Lee
Keitaro Matsuo
Nathaniel Rothman
You-Lin Qiao
Wei Zheng
Paolo Boffetta
Manami Inoue
Sue K. Park
author_facet Sangjun Lee
Choonghyun Ahn
Sarah Krull Abe
Md Shafiur Rahman
Md Rashedul Islam
Eiko Saito
Seokyung An
Norie Sawada
Xiao-Ou Shu
Woon-Puay Koh
Hui Cai
Atsushi Hozawa
Seiki Kanemura
Chisato Nagata
San-Lin You
Daehee Kang
Rieko Kanehara
Yu-Tang Gao
Jian-Min Yuan
Wanqing Wen
Yumi Sugawara
Keiko Wada
Chien-Jen Chen
Keun-Young Yoo
Habibul Ahsan
Kee Seng Chia
Aesun Shin
Jeongseon Kim
Jung Eun Lee
Keitaro Matsuo
Nathaniel Rothman
You-Lin Qiao
Wei Zheng
Paolo Boffetta
Manami Inoue
Sue K. Park
author_sort Sangjun Lee
collection DOAJ
description Background: Studies on the association between multimorbidity and mortality in large populations have mainly been conducted in European and North American populations. This study aimed to identify the association between cardiometabolic multimorbidity and all-cause and cardiovascular disease (CVD) mortality in the Asia Cohort Consortium. Methods: In this prospective cohort study, pooled analysis was performed to evaluate the association between cardiometabolic diseases (hypertension, diabetes, ischemic heart disease, and stroke), multimorbidity, and all-cause and CVD mortality, including premature mortality, among participants from 11 Asian cohort studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox hazard regression. Results: A total of 483,532 participants were followed for a median of 14.3 years. Compared with participants without any disease, those with stroke and diabetes had higher age- and sex-adjusted HRs for all-cause mortality (HR 3.9; 95% CI, 3.28–4.56). Moreover, the age- and sex-adjusted HRs for CVD mortality were highest in participants with stroke, ischemic heart disease, and diabetes (HR 10.6; 95% CI, 6.16–18.25). These patterns remained consistent after additional adjustments for smoking status and body mass index. The risk of premature mortality followed similar trends but was more pronounced. Conclusion: These findings highlight the differential impacts of individual cardiometabolic diseases and their combinations on mortality risks. Stroke and diabetes were associated with the highest risks for all-cause and cardiovascular mortality, underscoring the need for targeted prevention and personalized management strategies tailored to these high-risk conditions in Asian populations.
format Article
id doaj-art-d73aefa6c76d4f1886e6b4938c242530
institution DOAJ
issn 0917-5040
1349-9092
language English
publishDate 2025-07-01
publisher Japan Epidemiological Association
record_format Article
series Journal of Epidemiology
spelling doaj-art-d73aefa6c76d4f1886e6b4938c2425302025-08-20T03:15:19ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922025-07-0135732132910.2188/jea.JE20240362Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort ConsortiumSangjun Lee0Choonghyun Ahn1Sarah Krull Abe2Md Shafiur Rahman3Md Rashedul Islam4Eiko Saito5Seokyung An6Norie Sawada7Xiao-Ou Shu8Woon-Puay Koh9Hui Cai10Atsushi Hozawa11Seiki Kanemura12Chisato Nagata13San-Lin You14Daehee Kang15Rieko Kanehara16Yu-Tang Gao17Jian-Min Yuan18Wanqing Wen19Yumi Sugawara20Keiko Wada21Chien-Jen Chen22Keun-Young Yoo23Habibul Ahsan24Kee Seng Chia25Aesun Shin26Jeongseon Kim27Jung Eun Lee28Keitaro Matsuo29Nathaniel Rothman30You-Lin Qiao31Wei Zheng32Paolo Boffetta33Manami Inoue34Sue K. Park35Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaDepartment of Orthopaedic Surgery, National Hospital Organization Sagamihara Hospital, Kanagawa, JapanDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, JapanDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, JapanDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, JapanSustainable Society Design Center, Graduate School of Frontier Science, The University of Tokyo, Tokyo, JapanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaDivision of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, JapanDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USAHealthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USATohoku University Graduate School of Medicine, Miyagi Prefecture, Miyagi, JapanTohoku University Graduate School of Medicine, Miyagi Prefecture, Miyagi, JapanDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, JapanSchool of Medicine & Big Data Research Center, Fu Jen Catholic University, Taipei, TaiwanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaDivision of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, JapanDepartment of Epidemiology, Shanghai Cancer Institute, Shanghai, ChinaCancer Epidemiology and Prevention Program, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, USADivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USATohoku University Graduate School of Medicine, Miyagi Prefecture, Miyagi, JapanDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, JapanGenomics Research Center, Academia Sinica, Taipei, TaiwanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaDepartment of Public Health Sciences, University of Chicago, IL, USASaw Swee Hock School of Public Health, National University of Singapore, SingaporeDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaGraduate School of Cancer Science and Policy, National Cancer Center, Goyang, KoreaDepartment of Food and Nutrition, Seoul National University, Seoul, KoreaDivision Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, JapanDivision of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USASchool of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USAStony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USADivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, JapanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, KoreaBackground: Studies on the association between multimorbidity and mortality in large populations have mainly been conducted in European and North American populations. This study aimed to identify the association between cardiometabolic multimorbidity and all-cause and cardiovascular disease (CVD) mortality in the Asia Cohort Consortium. Methods: In this prospective cohort study, pooled analysis was performed to evaluate the association between cardiometabolic diseases (hypertension, diabetes, ischemic heart disease, and stroke), multimorbidity, and all-cause and CVD mortality, including premature mortality, among participants from 11 Asian cohort studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox hazard regression. Results: A total of 483,532 participants were followed for a median of 14.3 years. Compared with participants without any disease, those with stroke and diabetes had higher age- and sex-adjusted HRs for all-cause mortality (HR 3.9; 95% CI, 3.28–4.56). Moreover, the age- and sex-adjusted HRs for CVD mortality were highest in participants with stroke, ischemic heart disease, and diabetes (HR 10.6; 95% CI, 6.16–18.25). These patterns remained consistent after additional adjustments for smoking status and body mass index. The risk of premature mortality followed similar trends but was more pronounced. Conclusion: These findings highlight the differential impacts of individual cardiometabolic diseases and their combinations on mortality risks. Stroke and diabetes were associated with the highest risks for all-cause and cardiovascular mortality, underscoring the need for targeted prevention and personalized management strategies tailored to these high-risk conditions in Asian populations.https://www.jstage.jst.go.jp/article/jea/35/7/35_JE20240362/_pdfcardiometabolic multimorbidityprospective cohort studyasian populations
spellingShingle Sangjun Lee
Choonghyun Ahn
Sarah Krull Abe
Md Shafiur Rahman
Md Rashedul Islam
Eiko Saito
Seokyung An
Norie Sawada
Xiao-Ou Shu
Woon-Puay Koh
Hui Cai
Atsushi Hozawa
Seiki Kanemura
Chisato Nagata
San-Lin You
Daehee Kang
Rieko Kanehara
Yu-Tang Gao
Jian-Min Yuan
Wanqing Wen
Yumi Sugawara
Keiko Wada
Chien-Jen Chen
Keun-Young Yoo
Habibul Ahsan
Kee Seng Chia
Aesun Shin
Jeongseon Kim
Jung Eun Lee
Keitaro Matsuo
Nathaniel Rothman
You-Lin Qiao
Wei Zheng
Paolo Boffetta
Manami Inoue
Sue K. Park
Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
Journal of Epidemiology
cardiometabolic multimorbidity
prospective cohort study
asian populations
title Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
title_full Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
title_fullStr Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
title_full_unstemmed Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
title_short Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium
title_sort association between cardiometabolic multimorbidity and 15 year mortality in the asia cohort consortium
topic cardiometabolic multimorbidity
prospective cohort study
asian populations
url https://www.jstage.jst.go.jp/article/jea/35/7/35_JE20240362/_pdf
work_keys_str_mv AT sangjunlee associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT choonghyunahn associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT sarahkrullabe associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT mdshafiurrahman associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT mdrashedulislam associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT eikosaito associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT seokyungan associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT noriesawada associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT xiaooushu associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT woonpuaykoh associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT huicai associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT atsushihozawa associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT seikikanemura associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT chisatonagata associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT sanlinyou associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT daeheekang associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT riekokanehara associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT yutanggao associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT jianminyuan associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT wanqingwen associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT yumisugawara associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT keikowada associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT chienjenchen associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT keunyoungyoo associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT habibulahsan associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT keesengchia associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT aesunshin associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT jeongseonkim associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT jungeunlee associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT keitaromatsuo associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT nathanielrothman associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT youlinqiao associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT weizheng associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT paoloboffetta associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT manamiinoue associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium
AT suekpark associationbetweencardiometabolicmultimorbidityand15yearmortalityintheasiacohortconsortium