چکیده (انگلیسی):

Background:Cardiovascular diseases are highly represented in multimorbidity patterns. Nevertheless, few studies
have analysed the burden of these diseases in the population with multimorbidity. The objective of this study was
to identify and describe the cardiovascular diseases among the patients with multimorbidity.
Methods:We designed a cross-sectional study in patients≥19 years old assigned to 251 primary health care
centres in Catalonia, Spain. The main outcome was cardiovascular morbidity burden, defined as the presence of
one or more of 24 chronic cardiovascular diseases in multimorbid patients (≥2 chronic conditions). Two groups
were defined, with and without multimorbidity; the multimorbidity group was further divided into cardiovascular
and non-cardiovascular subgroups. The secondary outcomes were: modifiable major cardiovascular risk factors
(smoking, hypertension, hypercholesterolaemia, diabetes) and cardiovascular risk score (REGICOR, Registre Gironí del
Cor). Other variables analysed were: sex, age (19–24, 25–44, 45–64, 65–79, and 80+ years), number of chronic
diseases, urban setting, active toxic habits (smoking and alcohol), physical parameters and laboratory tests.
Results:A total of 1,749,710 individuals were included (mean age, 47.4 years [SD: 17.8]; 50.7 % women), of which
nearly half (46.8 %) had multimorbidity (95 % CI: 46.9–47.1). In patients with multimorbidity,, the cardiovascular
burden was 54.1 % of morbidity (95 % CI: 54.0–54.2) and the four most prevalent cardiovascular diseases were
uncomplicated hypertension (75.3 %), varicose veins of leg (20.6 %),“other” heart disease (10.5 %) and atrial
fibrillation/flutter (6.7 %). In the cardiovascular morbidity subgroup, 38.2 % had more than one cardiovascular
disease. The most prevalent duet and triplet combinations were uncomplicated hypertension & lipid disorder
(38.8 %) and uncomplicated hypertension & lipid disorder & non-insulin dependent diabetes (11.3 %), respectively.
By age groups, the same duet was the most prevalent in patients aged 45–80 years and in men aged 25–44 years.
In women aged 19–44, varicose veins of leg & anxiety disorder/anxiety was the most prevalent; in men aged 19–24,
it was uncomplicated hypertension & obesity. Patients with multimorbidity showed a higher cardiovascular risk
profile than the non-multimorbidity group.
Conclusions:More than 50 % percent of patients with multimorbidity had cardiovascular diseases, the most
frequent being hypertension. The presence of cardiovascular risk factors and the cardiovascular risk profile were
higher in the multimorbidity group than the non-multimorbidity group. Hypertension, diabetes and dyslipidaemia
constituted the most prevalent multimorbidity pattern.