title: Prevalence and outcomes of comorbid metabolic and cardiovascular conditions in middle- and older-age adults.
abstract: To estimate age group differences in the prevalence and outcomes of three common and often comorbid metabolic conditions (i.e., obesity, hypertension, and diabetes) and heart disease.
  
  
  METHODS
  Nationally representative prospective cohort study.
  
  
  METHODS
  PARTICIPANTS' homes.
  
  
  METHODS
  9825 adults aged 51 to 61 years (middle-age) in 1992, and 7370 adults aged 70 years and over (older-age) in 1993.
  
  
  METHODS
  Two-year dichotomous outcomes included: doctor visits, hospitalization, mobility difficulty, activity of daily living limitation, poor perceived health, and mortality. Odds ratios (OR) were adjusted for sociodemographic characteristics and history of cancer or lung disease.
  
  
  RESULTS
  Those with one condition represented 80% and 70% of the middle- and older-age groups, respectively, while just 1-2% of each age group reported all three metabolic conditions. Thirteen percent and 32%, respectively, reported heart disease with or without metabolic conditions. Diabetes comorbid with other metabolic conditions, and particularly with heart disease, substantially elevated the risk of adverse outcomes such as health-related quality of life deficits, health services use, and mortality in both middle- and older-age adults. In the middle-age group, the OR was 6.81 for mortality in patients with a combination of obesity and diabetes and 6.10 in those with a combination of heart disease and diabetes. There also were significant ORs for mortality in middle-aged patients with heart disease (OR = 2.40), diabetes (OR = 2.63) and for those with a combination of obesity, hypertension, and diabetes (OR = 3.26).
  
  
  CONCLUSIONS
  The impact of these often comorbid conditions underscores the importance of targeted and aggressive prevention, particularly among middle-age adults.
authors.affiliation: Indiana University Center for Aging Research, 1050 Wishard Blvd, RG-6, Indianapolis, IN 46202-2859, USA.
authors.forename: N B
authors.initials: NB
authors.lastname: Oldridge
authors.forename: T E
authors.initials: TE
authors.lastname: Stump
authors.forename: F K
authors.initials: FK
authors.lastname: Nothwehr
authors.forename: D O
authors.initials: DO
authors.lastname: Clark
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D015331:Cohort Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D014481:United States / Q000453:epidemiology