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Share on Pinterest The number of people dealing multiple chronic conditions is on the rise in the U.S.Hero Images Inc/Getty ImagesA study has found that adults in the U.S. are increasingly dealing with multiple chronic conditions.These cardiac, renal, and metabolic conditions include type 2 diabetes, heart disease, and kidney disease.These conditions are the leading cause of morbidity and mortality in the United States, and are estimated to account for every 1 in 3 deaths.

A new study found that the number of Americans with multiple cardiac, renal, and metabolic conditions is rising.

Approximately one in four adults have a cardiac, renal, or metabolic conditions condition and nearly 1 in 10 have multiple cardiac, renal, or metabolic conditions, according to the report, which published in JAMA Cardiology on September 27.

The risk of also increased with ageone in three adults 65 and older had a cardiac, renal, or metabolic condition, while almost 1 in 4 had overlapping conditions.

These conditions are the leading cause of morbidity and mortality in the United States and are estimated to account for every 1 in 3 deaths, according to study authors.

We have medications to treat the underlying mechanisms that contribute to co-existing cardiac, renal, and metabolic (CRM) conditions, however, they arent being prescribed or taken nearly as frequently as they should be.

The new report sheds light on how significantly the incidence of these conditions has grown over the past two decades along with the urgent need to address the situation.

The findings are doubly concerning as they demonstrate both an increase in the prevalence of cardiac, renal, and metabolic disease and concurrent high levels of undertreatment, Dr. Dmitriy Nevelev, Associate Director of Cardiology at Staten Island University Hospital, told Healthline. Nevelev wasnt involved in the study. Chronic conditions have become much more common since 1999

To determine the prevalence of CRM conditions in the U.S., the researchers evaluated health data from January 2015 through March 2020 sourced from the National Health and Nutrition Examination Survey (NHANES).

They compared those trends against NHANES health data collected between 1999 and 2002.

The analysis included 11,607 non-pregnant adults aged 20 and over.

Of the data pooled from 2015 to 2020, 26.3% had at least 1 CRM condition, 8% had at least two, and 1.5% had three CRM conditions.

The most common comorbid conditions were type 2 diabetes plus chronic kidney disease (3.2%), followed by cardiovascular disease plus type 2 diabetes (1.7%) and cardiovascular disease plus chronic kidney disease (1.6%).

The burden was greatest among non-hispanic Black individuals along with people who reported they were unemployed, of low socioeconomic status, or had no high school degree.

Disparities in access to healthcare services can result in delayed diagnosis and treatment of cardiac, renal, and metabolic conditions, leading to worse outcomes, said Dr. David Cutler, board certified family medicine physician at Providence Saint Johns Health Center in Santa Monica, CA. Cutler was not involved in the study.

Of those with three CRM conditions, roughly one-third (30.5%) did not report statin use, only 4.8% used medication common for weight loss and diabetes called glucagon-like peptide-1 receptor agonists (GLP1 agonists.) Additionally only 3% took medication commonly used to treat high blood sugar called sodium-glucose cotransporter 2 inhibitors (SGLT2).

Newer medications like GLP1 agonists for example, semaglutide and SGLT2 inhibitors which have been found to improve these conditions are very expensive and were found to be prescribed at a very low rate in this study, says Cutler.

The proportion of U.S. adults with multiple CRM conditions has grown significantly over the past few decades from 5.3% in 1999 to 8% in 2020.

The proportion of Americans with three CRM conditions also grew, from 0.7% in 1999 to 1.5% in 2020. How to combat the rising prevalence of multiple CRM conditions

Research shows that heart, kidney, and metabolic functions are intertwined and share the same risk factors, including obesity, hypertension, blood sugar that is too high or low, and cholesterol imbalance.

Diet and lack of physical activity can contribute to metabolic disorders and obesity, says Cutler.

Genetics, age, and access to healthcare play a role, too.

In addition, stress can affect health behaviors and contribute to the development of these conditions, he added.

The report says that issues with one body system may lead to dysfunction of others and the development of multiple morbidities.

Fortunately, we can use the common link between these conditions to personalize treatment and prevent their onset, says Nevelev.

There are drugs that target the underlying pathways involved in the development of comorbidities, such a SGLT2 inhibitors, and may help lower the prevalence of multiple conditions, however, they are being prescribed at a low rate.

Several factors are at play, including insurance coverage and the associated insurance authorizations burden, overall cost to the patient, prescriber comfort in using newer medications, fear of medication side effects, and in the case of GLP-1 antagonists availability, says Nevelev.

The rising prevalence of multiple conditions are expected to accelerate due to the COVID-19 pandemic.

We now have good data demonstrating pandemic-related decreases in physical activity and increases in sedentary activity and weight gain, he said.

The findings highlight the need to improve the situation and promote public health efforts, such as promoting healthy lifestyles, improving access to healthcare, and raising awareness about risk factors and early detection.

We have the tools to lower rates of these diseases. We have to make better use of them, says Cutler. The bottom line:

A new study found that the number of adults in the U.S. with multiple cardiac, renal, and metabolic (CRM) conditions is rising. There are medications to treat the underlying mechanisms that contribute to these co-existing conditions. However, they arent being prescribed or taken as frequently as they should be. The research sheds light on the urgent need to address the situation, ideally through awareness, screening, and improved access to healthcare.

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Putin humiliated by ‘Russia’s Pearl Harbor’ – as Kyiv goes for broke

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Putin humiliated by 'Russia's Pearl Harbor' - as Kyiv goes for broke

An audacious Ukrainian drone attack against multiple airbases across Russia is a humiliating security breach for Vladimir Putin that will doubtless trigger a furious response.

Pro-Kremlin bloggers have described the drone assault – which Ukrainian security sources said hit more than 40 Russian warplanes – as “Russia’s Pearl Harbor” in reference to the Japanese attack against the US in 1941 that prompted Washington to enter the Second World War.

Ukraine war latest: Russia accuses Kyiv of ‘terrorist attack’

The Ukrainian operation – which used small drones smuggled into Russia, hidden in mobile sheds and launched off the back of trucks – also demonstrated how technology and imagination have transformed the battlefield, enabling Ukraine to seriously hurt its far more powerful opponent.

Moscow will have to retaliate, with speculation already appearing online about whether President Putin will again threaten the use of nuclear weapons.

“We hope that the response will be the same as the US response to the attack on their Pearl Harbor or even harsher,” military blogger Roman Alekhin wrote on his Telegram channel.

Codenamed ‘Spider’s Web’, the mission on Sunday was the culmination of one and a half years of planning, according to a security source.

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In that time, Ukraine’s secret service smuggled first-person view (FPV) drones into Russia, sources with knowledge of the operation said.

Flat-pack, garden-office style sheds were also secretly transported into the country.

The drones were hidden in truck containers and the tops remotely lifted for the drones to be flown out to attack. Pic: SBU Security Service
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The drones were hidden in truck containers. Pic: SBU Security Service

The oblong sheds were then built and drones were hidden inside, before the containers were put on the back of trucks and driven to within range of their respective targets.

At a chosen time, doors on the roofs of the huts were opened remotely and the drones were flown out. Each was armed with a bomb that was flown into the airfields, with videos released by the security service that purportedly showed them blasting into Russian aircraft.

These drones were used to destroy Russian bomber aircraft. Pic: SBU Security Service
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These drones were used to destroy Russian bomber aircraft. Pic: SBU Security Service

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Among the targets were Tu-95 and Tu-22 bomber aircraft that can launch cruise missiles, according to the Ukrainian side. An A-50 airborne early warning aircraft was also allegedly hit. This is a valuable platform that is used to command and control operations.

The use of such simple technology to destroy multi-million-pound aircraft will be watched with concern by governments around the world.

Suddenly, every single military base, airfield and warship will appear that little bit more vulnerable if any truck nearby could be loaded with killer drones.

Read more:
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What new Stalin statue says about Putin’s regime

The most immediate focus, though, will be on how Mr Putin responds.

Previous attacks by Ukraine inside Russia have triggered retaliatory strikes and increasingly threatening rhetoric from the Kremlin.

But this latest operation is one of the biggest and most significant, and comes on the eve of a new round of peace talks between Moscow and Kyiv that are meant to take place in Turkey. It is not clear if that will still happen.

US President Donald Trump has been pushing for the two sides to make peace but Russia has only escalated its war.

Ukraine clearly felt it had nothing to lose but to also go on the attack.

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Eight injured in petrol bomb and ‘flamethrower’ attack at rally for Hamas-held hostages in Colorado

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Eight injured in petrol bomb and 'flamethrower' attack at rally for Hamas-held hostages in Colorado

Eight people have been injured at a US rally for Israeli hostages after they were attacked by a man with a makeshift flamethrower and petrol bombs.

A group of people in Boulder, Colorado, were holding a regular demonstration to raise awareness of Hamas-held hostages in Gaza when they were allegedly targeted by a man who shouted “Free Palestine” on Sunday. The suspect was arrested at the scene.

Four women and four men aged between 52 and 88 were injured and transported to hospitals, Boulder police said.

The force said the injuries ranged from “very serious” to “more minor”.

Some of the victims were airlifted to hospital.

Authorities had earlier put the count of the injured at six and said at least one of them was in a critical condition.

Topless attack suspect holds bottles
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Mohamed Soliman, 45, was holding several bottles

The FBI says the attack was a targeted “act of terrorism” and named the suspect as 45-year-old Mohamed Soliman from El Paso County, Colorado.

He was also taken to hospital after the alleged attack.

Eyewitnesses said the suspect threw Molotov cocktails, an improvised bomb made from a bottle filled with petrol and stuffed with a piece of cloth to use as a fuse, into people attending the demonstration.

He also used a “makeshift flamethrower” during the attack, according to Mark Michalek, special agent in charge of the FBI’s Denver field office.

Two senior law enforcement officials told Sky News’ US partner network that Soliman is an Egyptian national who seemingly acted alone. They said he has no previous significant contact with law enforcement.

Topless man being pinned down by police
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The ground appeared burned as the man was detained

Police pin down suspect as people help injured person
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People doused one of the victims with water as police arrested the suspect

The White House described the suspect as an “illegal alien” who had received a work permit under the Biden administration despite overstaying a tourist visa.

A large part of downtown Boulder was cordoned off as sniffer dogs and the bomb squad searched for potential devices.

Police chief Steve Redfearn said the attack happened around 1.26pm on Sunday and that initial reports were that “people were being set on fire”.

Smoke rises over a park area in Boulder as people look on
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Phone footage showed smoke rising from a distance

“When we arrived we encountered multiple victims that were injured, with injuries consistent with burns,” Mr Redfearn told the media.

The police chief also said he did not believe anyone else was involved.

“We’re fairly confident we have the lone suspect in custody,” he said.

Law enforcement officers detain a suspect, after an attack that injured multiple people, in Boulder, Colorado, U.S. June 1, 2025, in this pi
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The suspect is detained in Colorado. Pic: Reuters

Boulder’s police chief said the attack happened as a “group of pro-Israel people” were peacefully demonstrating.

The walk is held regularly by a volunteer group called Run For Their Lives, which aims to raise awareness of the hostages who remain in Gaza.

Video from the scene showed a bare-chested man shouting and clutching two bottles after the attack.

Other footage showed him being held down and arrested by police as people doused one of the victims with water.

Nearby there appears to be a large black burn mark on the ground.

Law enforcement officials were seen putting on protective gear to investigative the attack. Pic: AP
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Law enforcement used armoured suits as they searched for bombs. Pic: AP

Brooke Coffman, a 19-year-old student, described seeing four women on the ground with burns on their legs. She said one appeared badly burned on most of her body and had been wrapped in a flag.

She described seeing a man whom she presumed to be the attacker standing in the courtyard shirtless, holding a glass
bottle of clear liquid and shouting.

“Everybody is yelling, ‘get water, get water,'” Ms Coffman said.

Lady on fire ‘from head to toe’

Another eyewitness, who did not give his name, said: “It was very strange to just hear a crash on the ground of a bottle breaking and then it sounded like a boom and then people started yelling and screaming.

“But I saw fire, I saw people screaming and crying and tripping and I saw the attacker – he had three Molotov cocktails.

“One of them he threw inside a group and one lady lit on fire from head to toe and then the other four people were also injured in the fire, but not as bad as the first one.”

A bomb disposal robot with law enforcement on a Boulder street. Pic: AP
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A bomb disposal robot and sniffer dogs were also at the scene. Pic: AP

The eyewitness continued: “The attacker came out from the bushes and the trees… he threw another cocktail, and on the second one he lit himself on fire – I imagine accidentally.

“He seemed to have a bullet proof vest on, or some kind of vest, and then a shirt underneath it.

“And after he lit himself on fire he took off the vest and the shirt and he was shirtless.

“But he still had his Molotov cocktails in his hands ready to use them… ready to throw them and explode them on people.”

Lynn Segal, another eyewitness, said: “These shoots of fire, linear, about 20 feet long, spears of fire, two of them at least, came across right into the group, about 15 feet from me.”

The 72-year-old said two neighbours of hers, a husband and wife in their 80s, were at the demonstration. She added that the wife was one of the victims and appeared to be the most seriously injured.

“They’re both elders in their 80s, and you can’t take something like this assault to your body as easily as someone younger.”

Police lead a sniffer dog around cars. Pic: AP
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Pic: AP

Ms Segal, who was wearing a “Free Palestine” T-shirt, said she watches the demonstrations to “try and listen” to what the volunteers are “talking about” because she is concerned about the hostages.

She added that she is concerned the attack will “divide this community”.

Another eyewitness told MSNBC that he saw the suspect “lighting people on fire while spraying gasoline on them”.

Brian, who is himself Jewish and asked that his last name not be made public, added that he saw victims “having their skin melt off their bodies”.

A statement from Boulder’s Jewish community said “an incendiary device was thrown at walkers at the Run for Their Lives walk on Pearl Street as they were raising awareness for the hostages still held in Gaza”.

Israeli Prime Minister Benjamin Netanyahu said in a statement this morning: “This attack was aimed against peaceful people who wished to express their solidarity with the hostages held by Hamas, simply because they were Jews.

“I trust the United States authorities to prosecute the cold blood perpetrator to the fullest extent of the law and do everything possible to prevent future attacks against innocent civilians.

“The antisemitic attacks around the world are a direct result of blood libels against the Jewish state and people, and this must be stopped.”

US Senate Minority Leader Chuck Schumer, a prominent Jewish Democrat , said it was an antisemitic attack.

“This is horrifying, and this cannot continue. We must stand up to antisemitism,” he said on X.

A man pins a stick of an Israeli flag to a post near the attack scene. Pic: Reuters
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A man pinned a sticker of the Israeli flag to a post near the scene. Pic: Reuters

Boulder is a university city of about 105,000 people on the northwest edge of Denver, in the foothills of the Rocky Mountains.

The attack follows the arrest of a Chicago-born man in the fatal shooting of two Israeli embassy employees in Washington DC two weeks ago.

Read more from Sky News:
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IDF issues denial after reports at least 31 people killed

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Tensions are simmering in the US over Israel’s war in Gaza.

There has been an increase in antisemitic hate crime, as well as moves by some supporters of Israel to brand pro-Palestinian protests as antisemitic.

President Trump’s administration has detained protesters without charge and pulled funding from elite universities that have permitted such demonstrations.

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Trump-inspired candidate Karol Nawrocki wins Poland’s presidential election

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Trump-inspired candidate Karol Nawrocki wins Poland's presidential election

Conservative historian Karol Nawrocki, who draws inspiration from Donald Trump, has won Poland’s presidential election.

Mr Nawrocki secured 50.89% of votes while his opponent, Liberal pro-EU candidate Rafal Trzaskowski, took 49.11%.

Earlier, an exit poll called the result the other way around – with both men declaring victory.

Mr Nawrocki had positioned himself as a defender of traditional Polish values, aligning himself with US conservatives, including Mr Trump, and showing scepticism towards the EU.

Warsaw Mayor Rafal Trzaskowski gestures after the exit poll announcement of the second round of presidential election. Pic: Reuters
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Rafal Trzaskowski in Warsaw after the exit poll announcement. Pic: Reuters

Meanwhile, Mr Trzaskowski, 53, had promised to ease abortion restrictions, introduce civil partnerships for LGBT couples and promote constructive ties with European partners.

The vote has been closely watched in neighbouring Ukraine as well as in Russia, the European Union and the United States – with the election being framed as Poland choosing between more liberal norms or a more nationalist path.

Presidential candidate Karol Nawrock addresses supporters at his headquarters after the presidential election runoff in Warsaw, June 1
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Karol Nawrocki addresses his supporters. Pic: AP

This runoff follows a tightly-contested first round of voting in May, which saw Mr Trzaskowski win just over 31% and Mr Nawrocki nearly 30%, eliminating 11 other candidates.

More on Poland

Mr Nawrocki won the vote despite discussions about his past dominating the last days of the campaign – from questions over his acquisition of a flat from a pensioner to an admission that he took part in orchestrated brawls.

“Everything was on a knife edge,” said 32-year-old IT specialist Patryk Marek. “Feelings are for sure mixed for this moment. But how small this margin was, it tells us how divided we are almost in half as voters.”

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Outgoing Polish President Andrzej Duda spoke to Sky News earlier this year

Read more from Sky News:
Ukraine in ‘large-scale operation’ to destroy Russian bombers

Two dead and hundreds of arrests after PSG win

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Poland’s new president will have significant influence over whether the country’s centrist government can fulfil its agenda, given the presidential power to veto laws.

Led by Prime Minister Donald Tusk, the government had struggled to pass legislation with Poland’s previous president in power and may find the same is true once Mr Nawrocki is sworn in.

Like his predecessor, Mr Nawrocki is expected to block any attempts by the government to liberalise abortion or reform the judiciary.

European Commission President Ursula von der Leyen said she was convinced the EU could continue its “very good cooperation” with Poland.

“We are all stronger together in our community of peace, democracy, and values. So let us work to ensure the security and prosperity of our common home,” she said.

There has been some discussion about whether a win for Mr Nawrocki could lead to fresh elections in Poland.

Jacek Sasin, a politician for the opposition Law and Justice party, said: “The referendum on the dismissal of the Tusk government has been won.”

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