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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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China Advances Guowang Internet Constellation with Latest Satellite Launch

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China has launched the eighth batch of satellites for its Guowang internet constellation, lifting off on Aug. 13 aboard a Long March 5B rocket from Wenchang Space Launch Center. Operated by state-owned China SatNet, Guowang aims to deploy about 13,000 satellites in low Earth orbit to compete with SpaceX’s Starlink. Each launch so far has carried only eight to ten re…

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At least 56 dead and dozens missing after flash flooding in Indian Himalayas

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At least 56 dead and dozens missing after flash flooding in Indian Himalayas

At least 56 people have been killed after flash flooding hit a remote, mountainous village in Indian-controlled Kashmir.

Estimates suggest at least 80 people are still missing in the devastated Himalayan village of Chasoti, in the Jammu and Kashmir region, according to local officials.

Rescue teams have brought 300 people to safety, they added.

Chasoti, around 85 miles (136km) northeast of Jammu, is the last village accessible to vehicles on the route of an annual Hindu pilgrimage to a mountainous shrine, the Machail Mata temple.

The devastating floods swept away the main community kitchen, where more than 200 pilgrims were gathered, as well as dozens of vehicles and motorbikes, officials said.

At least 50 other people are reportedly still missing. Pic AP
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At least 50 other people are reportedly still missing. Pic AP

Abdul Majeed Bichoo, a local resident from a neighbouring village, said he witnessed the bodies of eight people being pulled out from under the mud.

The 75-year-old said Chasoti had become a “sight of complete devastation from all sides”.

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“It was heartbreaking and an unbearable sight,” he continued. “I have not seen this kind of destruction of life and property in my life.”

Chasoti is a remote village in the Jammu and Kashmir region
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Chasoti is a remote village in the Jammu and Kashmir region

India’s deputy minister for science and technology, Jitendra Singh, said the floods were triggered by torrential rains.

Sudden, intense downpours over small areas – known as cloudbursts – are increasingly common in India’s Himalayan regions, which are prone to flash floods and landslides.

Last week, floodwater crashed through an entire Himalayan village in India’s Uttarakhand state.

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Last week, flash flooding swept through a village in the Uttarakhand state

Television footage showed pilgrims in Chasoti crying in fear as water flooded the village.

At least 50 of the rescued people were badly injured and were being treated in local hospitals, local official Susheel Kumar Sharma said.

Officials said the Hindu pilgrimage, which began in July and was scheduled to end on 5 September, has been suspended. More rescue teams were on the way to the area, they added.

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Ramesh Kumar, the divisional commissioner of Kishtwar district, told news agency ANI that local police and disaster response officials had reached the scene.

“Army, air force teams have also been activated. Search and rescue operations are underway,” Mr Kumar said.

Indian Prime Minister Narendra Modi said “the situation is being monitored closely” and offered his prayers to “all those affected by the cloudburst and flooding.”

Cloudbursts can cause intense flooding and landslides, and have increased in recent years, partly due to climate change.

Damage from the storms has also been exacerbated by unplanned development in mountain regions.

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Israeli minister announces plans for new West Bank settlement to ‘bury’ idea of Palestinian state

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Israeli minister announces plans for new West Bank settlement to 'bury' idea of Palestinian state

Israel’s far-right finance minister has announced plans to build a new settlement in the Israeli-occupied West Bank, which he said would “bury” the idea of a Palestinian state.

Palestinians and rights groups said the settlement would effectively cut the West Bank into two separate parts and rob them of any chance to build a Palestinian state.

This comes as several countries, including the UK, said they would recognise a Palestinian state in September, unless Israel meets several conditions, including agreeing to a ceasefire in Gaza.

Israeli Finance Minister Bezalel Smotrich shows the settlement scheme on a map. Pic: Reuters/Ronen Zvulun
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Israeli Finance Minister Bezalel Smotrich shows the settlement scheme on a map. Pic: Reuters/Ronen Zvulun

“This reality finally buries the idea of a Palestinian state, because there is nothing to recognise and no one to recognise,” finance minister Bezalel Smotrich said as he announced the construction plans.

“Anyone in the world who tries today to recognise a Palestinian state will receive an answer from us on the ground.”

The settlement is planned to be built in E1, an open tract of land east of Jerusalem, and includes around 3,500 apartments to expand the existing settlement of Maale Adumim, Mr Smotrich said.

E1 has been eyed for Israeli development for more than two decades, but plans were halted due to pressure from the US during previous administrations.

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A view of part of the Israeli settlement of Maale Adumim. Pic: Reuters/Ronen Zvulun
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A view of part of the Israeli settlement of Maale Adumim. Pic: Reuters/Ronen Zvulun

Now-US President Donald Trump and the US ambassador to Israel, Mike Huckabee, were praised on Thursday by Mr Smotrich as “true friends of Israel as we have never had before”.

Mr Smotrich, himself a Jewish settler, told Sky News’ international correspondent Diana Magnay that Israeli Prime Minister Benjamin Netanyahu and Mr Trump had agreed to the revival of the E1 scheme. There was no confirmation of this claim from either leader.

The E1 plan has not yet received its final approval, which is expected next week.

Foreign Secretary David Lammy has said the UK strongly opposes the plan, calling it a “flagrant breach of international law and must be stopped now”.

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Is the two-state solution possible?

Construction of homes ‘within a year’

Peace Now, which tracks settlement activity in the West Bank, said some bureaucratic steps remain before construction could begin, including the approval of Israel’s high planning council.

But if the process moves quickly, infrastructure work could start in the next few months, with the construction of homes to follow in about a year.

“The E1 plan is deadly for the future of Israel and for any chance of achieving a peaceful two-state solution. We are standing at the edge of an abyss, and the government is driving us forward at full speed,” Peace Now said in a statement.

It added that the plan was “guaranteeing many more years of bloodshed”.

Palestinians inspect a facility damaged during an Israeli raid in the Israeli-occupied West Bank. Pic: Reuters/Raneen Sawafta
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Palestinians inspect a facility damaged during an Israeli raid in the Israeli-occupied West Bank. Pic: Reuters/Raneen Sawafta

Burnt cars are seen after an attack by Israeli settlers near Ramallah in the Israeli-occupied West Bank. Pic: Reuters/Ammar Awad
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Burnt cars are seen after an attack by Israeli settlers near Ramallah in the Israeli-occupied West Bank. Pic: Reuters/Ammar Awad

Mr Smotrich was also criticised by an Israeli rights group established by former Israel Defence Forces (IDF) soldiers, who accused the far-right politician of encouraging West Bank settlement activity while the world’s attention was on the Gaza war.

As well as official, government-approved settlements, there are also Israeli outposts, which are established without government approval and are considered illegal by Israeli authorities.

But reports suggest the government often turns a blind eye to their creation.

Israeli heavy machinery demolishes a Palestinian building near Bethlehem in the Israeli-occupied West Bank. Pic: Reuters/Mussa Qawasma
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Israeli heavy machinery demolishes a Palestinian building near Bethlehem in the Israeli-occupied West Bank. Pic: Reuters/Mussa Qawasma

In May, Mr Netanyahu’s government approved 22 new settlements, including the legalisation of outposts that had previously been built without authorisation.

Since the Hamas-led attacks on 7 October 2023 and Israel’s subsequent military bombardment of Gaza, more than 100 Israeli outposts have been established, according to Peace Now.

Settler violence against Palestinians has also increased, according to the UN, with an average of 118 incidents each month – up from 108 in 2023, which was already a record year.

Smotrich’s dreams of West Bank annexation never been closer to reality


Diana Magnay

Diana Magnay

International correspondent

@DiMagnaySky

Bezalel Smotrich is pumped. His dreams of resettlement and annexation of the West Bank have never been closer to fruition. 

The E1 settlement plan, which would cut the West Bank from East Jerusalem, was first conceived back in 1995 by then prime minister Yitzhak Rabin.

Thirty years later, the extremist settler contingent within the government seems to be on the verge of making it a reality.

The prime minister’s office has yet to confirm Benjamin Netanyahu’s backing, but according to Smotrich, both he and President Trump are on board.

E1 (or T1 as they say they will call it, in honour of Donald Trump) would be another symbolic blow to the very notion of Palestinian statehood, as is every settlement and piece of related infrastructure which Israel builds in the occupied West Bank.

At a time when the UK, France and others all say they will recognise a Palestinian state unless Israel pushes for a ceasefire in Gaza, Netanyahu’s government is doubling down.

Per Smotrich, their response will come through roads, buildings, neighbourhoods, the spread of Jewish life across Palestinian lands in the West Bank – the creation of facts on the ground. 

The UK, France and many others in the international community may not like it, but the real power-broker here, certainly as far as Netanyahu is concerned, is Donald Trump.

He is the president who moved the US embassy to Jerusalem; his ambassador has said there is no such thing as the West Bank.

For the likes of Smotrich, that is all the encouragement they need.

Plans criticised as ‘extension of genocide’

The Palestinian foreign ministry called the settlement plan an extension of the crimes of genocide, displacement and annexation. Israel has long disputed accusations of genocide and rights abuses, saying it is acting in self-defence.

Nabil Abu Rudeineh, the Palestinian president’s spokesperson, called on the US to pressure Israel to stop the building of settlements.

Hamas said the plan was part of Israel’s “colonial, extremist” policies and called on Palestinians to confront it.

Qatar, which has been acting as a mediator between Hamas and Israel in a bid to secure a ceasefire in Gaza, said the move was a flagrant violation of international law.

“The EU rejects any territorial change that is not part of a political agreement between involved parties. So annexation of territory is illegal under international law,” European Commission spokesperson Anitta Hipper said.

Today, an estimated 700,000 Israeli settlers live in the West Bank and East Jerusalem. There is also a growing movement of Israelis wanting to build settlements in Gaza.

Settlers make up around 5% of Israel’s population and 15% of the West Bank’s population, according to data from Peace Now.

Settlements are illegal under international law and have been condemned by the UN. They are, however, authorised by the Israeli government.

Israeli troops stand guard during a weekly settlers' tour in Hebron, in the Israeli-occupied West Bank. Pic: Reuters/Mussa Qawasma
Image:
Israeli troops stand guard during a weekly settlers’ tour in Hebron, in the Israeli-occupied West Bank. Pic: Reuters/Mussa Qawasma

According to the Israel Policy Forum, the settlement programme is intended to protect Israel’s security, with settlers acting as the first line of defence “against an invasion”.

Mr Smotrich’s settlement announcement comes after the UK, Canada, Australia and New Zealand on Mr Smotrich and his fellow far-right cabinet member, Itamar Ben-Gvir, for “repeated incitements of violence against Palestinian civilians” in the West Bank.

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Stuart Ramsay on West Bank settlers

Foreign Secretary David Lammy said in June that the ministers had been “encouraging egregious abuses of human rights” for “months”.

Last year, Mr Smotrich, whose National Religious Party largely draws its support from settlers, ordered preparations for the annexation of the West Bank.

His popularity has fallen in recent months, with polls showing that his party would not win a single seat in parliament in elections were held today.

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