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

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2 years 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

Putin has agreed Ukraine can have ‘NATO-style’ security guarantee, Trump envoy says

Published

41 mins ago

August 17, 2025

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Putin has agreed Ukraine can have 'NATO-style' security guarantee, Trump envoy says

Vladimir Putin has agreed to allow Ukraine’s allies to offer it a NATO-like security guarantee as part of an eventual deal to end the war, according to US special envoy Steve Witkoff.

Mr Witkoff said the Russian president agreed to the move when he met with Donald Trump in Alaska on Friday.

Speaking to CNN on Sunday, Mr Witkoff, who was by the US president’s side at the summit, said: “We were able to win the following concession: That the United States could offer Article 5-like protection, which is one of the real reasons why Ukraine wants to be in NATO.”

Article 5 is a core principle of the 32-member collective, which states that an armed attack against one or more of its members shall be considered an attack against all. It has only been invoked once, by the US, in the wake of the 9/11 attacks in 2001.

Russia has repeatedly insisted that Ukraine cannot be allowed to join NATO and has dismissed the idea that NATO member forces could be peacekeepers under some sort of ceasefire deal.

Mr Witkoff, who has previously met with Mr Putin to discuss an end to the Ukraine war, said Friday’s summit was the first time he had heard the Russian president agree to the suggestion of NATO-like protection – and called it “game-changing”.

His comments came as Volodymyr Zelenskyy met with European Commission President Ursula von der Leyen in Brussels.

The Ukrainian president said in a post on X: “This is a historic decision that the United States is ready to take part in security guarantees for Ukraine.

“Security guarantees, as a result of our joint work, must really be very practical, delivering protection on land, in the air, and at sea, and must be developed with Europe’s participation.”

Ms von der Leyen, speaking at a news conference with the Ukrainian president, said the European Union “is ready to do its share”.

EU leaders to join Zelenskyy at White House

Sunday afternoon also saw Ms von der Leyen and Mr Zelenskyy dial in to a meeting with the coalition of the willing, a peacekeeping alliance of European leaders – some of whom will accompany Mr Zelenskyy to meet with Mr Trump tomorrow.

Ms von der Leyen will be at the crunch talks in Washington DC, as will Sir Keir Starmer, France’s Emmanuel Macron and Italy’s Giorgia Meloni.

Germany’s Chancellor Friedrich Merz and NATO Secretary General Mark Rutte will also be in attendance, after the US president reportedly extended an invitation to European leaders.

Mr Putin has reportedly made demands to take control of the eastern Donetsk and Luhansk regions of Ukraine during his summit with Mr Trump as a condition for ending the war.

In exchange, Russia would give up other Ukrainian territories held by its troops, according to several news reports citing sources close to the matter.

Russian troops currently occupy large parts of the two regions and, in September 2022, Moscow announced it was officially annexing them, alongside the Kherson and Zaporizhia regions, in a move rejected and condemned as illegal by the West.

Mr Trump is said to be planning to urge Mr Zelenskyy to agree to the conditions as part of a peace deal to end the war.

That’s despite the Ukrainian president previously ruling out formally handing any territory to Moscow, which he says would be impossible under the country’s constitution, and would deprive Ukraine of defensive lines and open the way for Moscow to conduct further offensives.

In coordinated statements following the Alaska summit, European leaders said Mr Zelenskyy must play a greater role in future talks, and that peace cannot be achieved without him.

The US president said the Washington talk with Mr Zelenskyy could potentially pave the way for a three-way meeting with Mr Putin.

On Saturday, Downing Street insisted Sir Keir and other allies stand ready to support the next phase of talks to end the war.

“At the meeting that will take place at the White House tomorrow, the Prime Minister, with other European partners, stands ready to support this next phase of further talks and will reaffirm that his backing for Ukraine will continue as long as it takes,” a statement from No 10 said.

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