Nearly 1 in 10 U.S. Adults Have Multiple Chronic Conditions Such as Diabetes, Heart Disease

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1 year ago

September 29, 2023

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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.

World

Pope Francis has ‘initial, mild’ kidney problem and still in critical condition, says Vatican

Published

5 hours ago

February 23, 2025

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Pope Francis has 'initial, mild' kidney problem and still in critical condition, says Vatican

The Pope remains in a critical condition and is now showing an “initial, mild” kidney problem – but is “vigilant” and took part in Mass in hospital with those caring for him.

The Vatican statement said Francis hadn’t had any more “respiratory crises” since Saturday evening.

However, a problem with his kidneys has emerged, with blood tests showing “an initial, mild, renal insufficiency, which is currently under control”, according to the update.

The 88-year-old Pope is still having “high-flow oxygen therapy” into his nose, while his hemoglobin value has increased after being given blood transfusions on Saturday.

The Pope has been at Rome’s Gemelli hospital since 14 February and is being treated for double pneumonia and chronic bronchitis.

Sunday evening’s statement said he was “vigilant and well oriented”, but due to the complexity of his case the prognosis is “reserved”.

“During the morning, in the apartment set up on the 10th floor, he participated in the Holy Mass, together with those who are taking care of him during these days of hospitalization,” the update added.

On Sunday morning, the Vatican said the Pope had a “tranquil” night and confirmed he would not lead prayers for the second week running.

Instead, Francis, who has been Pope since 2013, prepared words to be read on his behalf at the recitation of the Angelus.

‘I ask you to pray for me’

The Pope’s message said: “I am confidently continuing my hospitalisation at the Gemelli Hospital, carrying on with the necessary treatment; and rest is also part of the therapy!

“I sincerely thank the doctors and health workers of this hospital for the attention they are showing me and the dedication with which they carry out their service among the sick.

“In recent days I have received many messages of affection, and I have been particularly struck by the letters and drawings from children.

“Thank you for this closeness, and for the prayers of comfort I have received from all over the world! I entrust you all to the intercession of Mary, and I ask you to pray for me.”

The message is understood to have been written in the last few days.

On Saturday night, the Vatican said the Pope was in a critical condition after a “prolonged respiratory crisis” that required a high flow of oxygen.

It said he’d had blood transfusions after tests revealed thrombocytopenia, which is associated with anaemia.

Millions around the world have been concerned about his increasingly frail health – and his condition has given rise to speculation over a possible resignation.

Faith is never lost but it feels optimism is fading

By Lisa Holland, Sky correspondent in Vatican City

It’s hard to imagine a Sunday in the Vatican City without the Pope. Every week – unless he’s travelling – he is a constant, appearing at the same Vatican windows to deliver his message.

Instead, his written words were distributed by Vatican officials. In his message, the Pope thanked his doctors and people around the world for their good wishes.

But it seems the upbeat message was written before the dramatic downturn in the Pope’s health, which has left him in a critical condition. The business and the events of the Church are continuing in his absence.

Faith is never lost but it feels like optimism is fading and we are living through the last days of Pope Francis.

In St Peter’s Square the sun shone – and a gentle light fell on the ancient stone of the basilica.
The beauty and pageantry of columns of deacons and visitors filing in for a special mass as part of the Catholic Church’s jubilee year sat awkwardly with the prognosis of the Pope’s ailing health.

The visitors and deacons who’d come from around the world to take part, and hoped to see the Pope, were left disappointed. Though they said they felt his presence. “It is what it is,” said one.

They know the Pope is an 88-year-old man who has spent the last few years assisted by a wheelchair and walking stick. Throughout his life he has been dogged by lung issues.

It leaves an almost philosophical mood ahead of what the coming days may bring.

Doctors said on Friday that he was “not out of danger” and was expected to remain in hospital for at least another week.

They also warned that while he did not have sepsis, there was always a risk the infection could spread in his body.

Sepsis is a complication of an infection that can lead to organ failure and death.

Pope Francis has a history of respiratory illness, having lost part of one of his lungs to pleurisy as a young man. He also had an acute case of pneumonia in 2023.

Environment

Volvo Penta set to show off its new BESS subsystem at bauma 2025

Published

7 hours ago

February 23, 2025

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Volvo Penta set to show off its new BESS subsystem at bauma 2025

Volvo Penta BESS subsystem to be Bauma highlight

Volvo Penta will debut its latest modular and scalable battery energy storage system (BESS) platform for the off-grid construction and mining industries at the bauma equipment show – here’s what you can expect.

Best-known for its marine engines and gensets, Volvo Penta is the power production arm of the Volvo Group, specializing in putting energy to work. Operating under the tagline, ‘Made to Move You’, Volvo Penta is headed to bauma 2025 with a plan to keep construction, port shipping, and mining operations moving productively and competitively throughout their transitions to battery and (in theory, at least) hydrogen power.

To that end, the company will show off a job site ready version of the scalable and modular BESS subsystem concept shown last year.

Volvo says its new, modular BESS subsystem will enable other OEMs and third party system integrators to seamlessly deploy electric power to meet the ever-exceeding energy needs in construction and mining.

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“Our modular and scalable battery-electric platform is designed to support the electrification ecosystem—combining high-performance drivelines with the crucial energy storage subsystems for efficient charging and operation in construction and mining,” says Hannes Norrgren, President of Volvo Penta Industrial. “We want to meaningfully collaborate with our customers on value-added customization that will enable them to stay productive, efficient, and future-ready.”

The Penta substation at bauma will be built around the company’s “Cube” battery pack, an energy-dense solution with a favorable C-rate designed to make it easy for BESS manufacturers to offer more compact job site solutions capable of charging and discharging energy with high levels of speed and efficiency, enabling both stationary and mobile BESS configurations that can change and grow to meet the evolving needs of a given asset fleet or project.

A Volvo Penta-developed DC/DC unit converts the voltage from the Cube battery packs (600 V) into lower voltage (24 V) for powering auxiliaries and portable offices.

Electrek’s Take

BESS concept packed with Penta Cube batteries; via Volvo.

Volvo Penta has always provided power. Historically that’s been from combustion, but the company is looking ahead, developing products that will bring energy to job sites, tractors, and more long after the last ICE engine shuts down.

SOURCE | IMAGES: Volvo Penta.

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World

Exit poll may appear decisive – but path to coalition is not clear yet

Published

7 hours ago

February 23, 2025

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Exit poll may appear decisive - but path to coalition is not clear yet

Initial exit polls appear to confirm what we have known for weeks: that the conservative Christian Democrats (CDU) and their Bavarian sister party the Christian Social Union (CSU) have got the most votes in the federal election, with Friedrich Merz most likely to be the next chancellor.

While this result isn’t a surprise, it doesn’t mean the path to power will be easy.

First off, the CDU-CSU don’t have a majority so they need to try to build a coalition.

Their most obvious choices as partners are the third-place Social Democrats. A two-party coalition is preferred as it can avoid excess bickering but the SPD and CDU disagree on several key points including sending long-range Taurus cruise missiles to Ukraine.

Follow live: Germany’s election results

Forming a government can take months but Mr Merz is keen to speed up the process – aware of the pressing issues both at home and abroad.

One of those is the rise of the far right, with the Alternative for Germany (AfD) party celebrating historic results.

The initial results suggest that for the first time since the Second World War, a far-right party has got the second highest number of votes.

That could also cause serious issues for the next government.

As a result of Germany‘s Nazi history, mainstream parties have a long-running pact known as the “firewall” which says they will not work with the far right.

Even before the polls had closed, AfD leader Alice Weidel echoed Donald Trump and released a video statement urging people to “observe” the ballots being counted and to “protect democracy”.

Many of the AfD’s supporters have said not allowing the second most popular party into government is undemocratic, threatening to take to the streets.

The US vice president JD Vance also sparked outrage when he spoke out against the firewall at the recent Munich Security Conference and suggested the new Trump administration would be ready to work with the AfD.

Conversely, in the run-up to the election, hundreds of thousands of Germans have protested to demand that the firewall remains.

In January, Mr Merz caused controversy when a draft motion got through parliament with AfD support, he’s since vowed he will not go into government with them.

If he sticks to that pledge then he is likely to see right-wing demonstrations as well becoming a target of prominent AfD backers including Elon Musk.

The AfD’s result also cannot be ignored. While some of the vote may be a protest, the party has expanded its traditional base in the east to pick up support in the west.

Dissatisfaction over migration, the economy, rocketing prices and the war in Ukraine have all helped to grow its ranks as people feel ignored by mainstream parties.

Mr Merz has already tried to win back some of its voters by proposing tough migration reforms including permanent checks on the borders and potentially turning away some asylum seekers when they try to enter.

If he fails to deliver on these promises then the AfD will continue to make gains.

Other urgent to dos for the next government include sorting out Germany’s economy following two years of recession and restoring its position at the centre of the EU.

Ministers must also face up to the fact their traditional allies are no longer guaranteed.

The Trump administration appears to be ripping up the rule book when it comes to being a protector of Europe and its ongoing support for Ukraine.

If America steps back, as Europe’s largest power and Ukraine’s largest European backer, Germany will have to step up.

Again, that’s going to be a big challenge as its military needs to be transformed.

The final results are not even confirmed yet but whatever form it takes, the next government knows it has four years to fix Germany, if it fails then populists are highly likely to ride to power in 2029.