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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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Discord hack shows dangers of online age checks as internet policing hopes put to the test

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Discord hack shows dangers of online age checks as internet policing hopes put to the test

Messaging platform Discord has said the official ID photos of around 70,000 users have been stolen by hackers.

The app, which is popular with gamers and teenagers, said the hackers targeted a firm responsible for verifying the ages of its users. Discord said its own platform was not breached.

The stolen data could include personal information, partial credit card numbers and messages with Discord’s customer service agents, the firm said.

No full credit card details, passwords or messages and activity beyond conversations with Discord customer support were leaked, it added.

Discord said it had revoked the third-party service’s access and was continuing to investigate. It said all affected users have been contacted.

“Looking ahead, we recommend impacted users stay alert when receiving messages or other communication that may seem suspicious,” it said.

Until recently, a hack like this could not have happened, because companies had no need to process and collect proofs of age.

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Now, so many governments are following the UK and introducing age verification for unsuitable or pornographic content that a company like Discord has to roll out age checks for a decent portion of its 200 million active users.

It’s a bit like the way that shops have to check your age if you’re buying alcohol – only because it’s online, it comes with a lot of additional complications.

Pic: Shutterstock
Image:
Pic: Shutterstock

A shop, for instance, won’t keep a copy of your passport once they’ve checked your age.

And it definitely won’t keep it in a massive (yet strangely light) safe along with thousands of other passport photocopies, stored right by its front door, ready to be taken.

Online, it’s surprisingly easy to do just that.

Read more on Sky News:
AI ‘distorting women online’
Pros and cons of digital IDs
Impact of new online safety rules

It’s worth noting that the age verification system used by Discord wasn’t hacked itself. That system asked people to take a photo of themselves, then used software to estimate their age. Once the check was complete, the image was immediately deleted.

The problem came with the appeals part of the process, which was supplied to Discord by an as-yet-unnamed third party.

If someone thought that the age verification system had wrongly barred them from Discord they could send in a picture of their ID to prove their age. This collection of images was hacked. As a result, Discord says, more than 70,000 IDs are now in the possession of hackers.

(The hackers themselves claim that the number is much bigger – 2,185,151 photos. Discord says this is wrong and the hackers are simply trying to extort money. It’s a messy situation.)

There are ways to make age verification safer. Companies could stop storing photo ID, for instance (although then it would be impossible to know for sure if their checks were correct).

And advocates of ID cards will point out that a proper government ID could avoid the need to send pictures of your passport simply to prove your age. You’d use your digital ID instead, which would stay safely on your device.

But the best way to stop data being hacked is not to collect it in the first place.

We’re at the start of a defining test – can governments actually police the internet? Or will the measures that are supposed to make us safer actually end up making us less secure?

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‘Bring it on’: Left-wing activists gather for fight back against the right – and Labour

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'Bring it on': Left-wing activists gather for fight back against the right - and Labour

The World Transformed, a left-wing political festival, has historically ran alongside the Labour Party Conference as an unofficial fringe event.

But a lot has changed since it began in 2016, organised then by the Corbyn-backed group Momentum. And like the former Labour leader himself, TWT has gone independent.

From Thursday to Sunday, a programme of politics, arts and cultural events will be held in Manchester, a week after Labour’s annual party gathering ended.

“It no longer made any sense to be a fringe festival of the Labour conference,” Hope Worsdale, an organiser since 2018, tells Sky News. “We need a space for the independent left to come together.”

This decision was made before the formation of Your Party in July and the surge of support behind the Greens and its new leader Zack Polanski, but both these factors have given TWT some extra momentum. Organisers say it is not just a festival, but a “statement of intent from the British left” – and a left that looks different from how it used to.

Previous headline speakers were Labour MPs in the left-wing Socialist Campaign Group, and in 2021, the showstopper was American democrat Bernie Sanders calling in live for an event alongside John McDonnell.

The World Transformed, previously headlined left-wing Labour MPs
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The World Transformed, previously headlined left-wing Labour MPs

Bernie Sanders and John McDonnell in conversation at TWT in 2021
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Bernie Sanders and John McDonnell in conversation at TWT in 2021

This year, Mr Polanski, Jeremy Corbyn and Zarah Sultana are the only British politicians due to speak at events – though Brian Leishman, who lost the Labour whip in the summer, is also scheduled on a panel.

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TWT was put on pause last year for organisers to reflect upon its role going forward, after Sir Keir Starmer’s election victory.

In 2021, 2022 and 2023, while he was leader of the opposition, the festival was able to “co-exist” with Labour as a space for activists on the left to discuss ideas.

But the prime minister’s “shift to the right” has alienated so many of those grassroots members that it was felt TWT’s core audience would no longer be at Labour Party conferences, says Hope, who joined Labour in the Corbyn years and has since left.

TWT in 2016. Pic: TWT
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TWT in 2016. Pic: TWT

Event at TWT in 2023
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Event at TWT in 2023

“Our official position isn’t that Labour is dead and no one should engage with it,” she says.

“But they have shifted the values of Labour so radically since the last election, broken promise after promise, attacked civil liberties… there’s been such a suite of terrible decisions that mean people who are generally progressive and generally left wing feel like they have to take their organising elsewhere.”

So what’s on the cards?

There will be 120 events held in Hulme, Manchester, from Thursday to Sunday evening.

At the heart of the programme is daily assemblies, which organisers say are “designed to hold genuinely constructive debates about what we should do and how we should do it”.

But there’s just as much partying as there is politics – Dele Sosimi and his Afrobeat Orchestra are headlining the Saturday night slot while a “mystery guest” will host what TWT calls its “infamous” pub quiz on Friday night.

Back in 2018 that was Ed Miliband’s job, when 10,000 activists were expected to attend TWT. This year, organisers anticipate around 3,000 people will gather, but those involved insist this is a real chance for the left to strategise and co-ordinate, given the involvement of over 75 grassroots groups, trade unions, and activist networks.

Collaboration ‘vital’

A key question the left will need to address is how it can avoid splitting the vote given the rise of the Greens, socialist independents and the formation of Your Party,

One activist from the We Deserve Better organisation, which is campaigning for a left-wing electoral alliance and will be at TWT this weekend, acknowledged collaboration is “vital” if the left is to make gains under Britain’s first-past-the-post system.

Jeremy Corbyn at TWT. Pic: Reuters
Image:
Jeremy Corbyn at TWT. Pic: Reuters

But it remains to be seen whether Your Party co-leaders Mr Corbyn and Ms Sultana can even work together following their public spat last month, let alone with other parties. The pair put on a united front at a rally in Liverpool on the eve of TWT, when Sultana said she was “truly sorry” and promised “no more of that”. But will the truce last?

“It’s not ideal”, says the activist. “Hopefully they are back on track…a lot of collaboration is happening at the grassroots and we need to make sure it’s formalised so we can beat Labour and the right, we need to put on united front.”

They point to seats like Ilford North, where Health Secretary Wes Streeting clung on by a margin of just 528 votes in the general election, after a challenge from British-Palestinian candidate Leanne Mohamad, who ran in protest against Labour’s stance on Gaza.

Meanwhile, in Hackney, the Greens are hoping to gain their first directly elected mayor next May, with the Hackney Independent Socialist Group of councillors throwing their weight behind the party’s candidate, Zoe Garbett.

The We Deserve Better activist says Labour’s “hostile war on the left” has made these areas ripe for the taking, and what is more important than party affiliation is galvanising momentum behind one candidate who shares socialist values on issues like public ownership and immigration – be they the Greens, independents, or Your Party.

“The World Transformed reflects a general reorientation of the left outside of Labour. If they are taking these places for granted, we are going to win. If we unite as the left then we can win even bigger. Bring it on.”

Is Labour in danger?

There is some cause for Labour to be worried. It is haemorrhaging votes to both the right and the left after a tumultuous first year in office (13% to Reform UK, 10% to the Greens and 10% to the Lib Dems, according to an Ipsos poll in September).

Many Labour MPs feel the prime minister has spent too much energy trying to “out Reform Reform” with a focus on immigration, and he needs to do more to win back moderate and progressive voters that will be gathering at TWT this weekend.

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Starmer’s ‘anti-Reform party’ gamble

One fed-up MP told Sky News it was a shame TWT had decided to branch away from Labour, but not a surprise.

“This was something that was on the cards for a while, a parting of the ways, it’s another thing to show what’s happening with the direction of the party.”

He said in previous years the festival “was full of people for the first time in their life who were excited about politics and had a leadership looking at how it could challenge the biggest issues in our country”.

“Debates could be heated but it was always a place for intellectual discussion and that inside the Labour Party is now dead.”

But he said the party ultimately had bigger things to worry about than TWT, with a budget round the corner and potentially catastrophic local elections in May.

“I don’t think it will keep Keir Starmer or Morgan McSweeney up at night.”

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Letitia James indicted for fraud after Donald Trump demanded case against New York attorney general

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Letitia James indicted for fraud after Donald Trump demanded case against New York attorney general

Letitia James – New York attorney general and long-time critic of Donald Trump – has been indicted for fraud.

Ms James, a Democrat, was charged on Thursday with one count of bank fraud and one count of making false statements to a financial institution, in connection with a home she purchased in Norfolk, Virginia, in 2020.

The 66-year-old could face up to 30 years in prison and up to a $1m (£752m) fine on each count if convicted, according to Sky’s US partner network NBC News.

Mr Trump has been advocating charging Ms James for months, posting on social media without citing any evidence that she’s “guilty as hell” and telling reporters at the White House: “It looks to me like she’s really guilty of something, but I really don’t know.”

Trump had been pushing for Ms James to be indicted. Pic: AP
Image:
Trump had been pushing for Ms James to be indicted. Pic: AP

In a lengthy statement, Ms James vehemently denied any wrongdoing and described the indictment as “nothing more than a continuation of the president’s desperate weaponisation of our justice system”.

She said: “These charges are baseless, and the president’s own public statements make clear that his only goal is political retribution at any cost.”

The indictment was presented to a grand jury by Lindsey Halligan, the newly appointed attorney for the Eastern District of Virginia.

Ms Halligan, who has previously worked as a lawyer for Mr Trump, replaced veteran prosecutor Erik Siebert, who had resisted filing charges against Ms James and former FBI director James Comey, who was charged with lying to Congress two weeks ago.

Former FBI director James Comey. Pic: Reuters
Image:
Former FBI director James Comey. Pic: Reuters

The indictment pertains to Ms James’s purchase of a house in Norfolk, where she has family.

During the sale, she allegedly signed a document called a “second home rider” in which she agreed to keep the property primarily for her “personal use and enjoyment for at least one year”. However, the indictment claims she instead rented it out to a family of three.

According to the indictment, the misrepresentation allowed Ms James to obtain favourable loan terms that are not available for investment properties.

Lindsey Halligan brought the case against Letitia James. Pic: AP
Image:
Lindsey Halligan brought the case against Letitia James. Pic: AP

History of Trump and James

Ms James’s indictment is the latest indication that the Trump administration is determined to use the powers of the justice department to target the president’s political and public figure foes.

In a statement on Truth Social last month, Mr Trump called on US Attorney General Pam Bondi, who leads the department, to prosecute his political opponents.

“We can’t delay any longer, it’s killing our reputation and credibility. They impeached me twice, and indicted me (5 times!), OVER NOTHING. JUSTICE MUST BE SERVED, NOW!!!” Trump wrote.

Ms James is a particularly personal target of Mr Trump. During the president’s first term in office, she sued him and his administration dozens of times.

Last year, she won a staggering judgment against the Trump Organization after she brought a civil lawsuit alleging he and his companies defrauded banks by overstating the value of his real estate holdings on financial statements.

An appeals court later overturned a hefty fine Mr Trump was ordered to pay, but upheld a lower court’s finding that he had committed fraud.

Ms James in court during Trump's civil fraud trial in 2024. Pic: Reuters
Image:
Ms James in court during Trump’s civil fraud trial in 2024. Pic: Reuters

What happens now?

Ms James is scheduled to make an initial appearance in the federal court in Norfolk on 24 October.

The case has been assigned to US District Judge Jamar K Walker, who was appointed by Joe Biden.

The standard for securing an indictment before a federal grand jury is much lower than securing a unanimous conviction by a jury at trial, NBC reported.

The Justice Manual, which guides federal prosecutors, says attorneys for the government should move forward on a case only if they believe the admissible evidence – evidence that is allowed to be presented in a court of law – would be enough to obtain and sustain a conviction.

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