Multimorbidity and the Risk of Sudden Cardiac Death: Findings From a Prospective Cohort Study.

Abstract

To assess the prospective associations of multimorbidity status and level with the risk of sudden cardiac death (SCD). Multimorbidity was defined as the presence of at least two multiple long-term conditions (hypertension, cardiovascular disease, type 2 diabetes, chronic kidney disease, chronic bronchitis, and other chronic lung conditions) among 2598 men 42 to 61 years of age who were recruited into the KIHD (Kuopio Ischemic Heart Disease) study from March 1, 1984, to December 31, 1989. Hazard ratios with 95% CIs were estimated. During a median follow-up of 27.8 years, 296 SCDs were recorded. In analysis adjusted for several established cardiovascular risk factors including socioeconomic and lifestyle characteristics, the HR (95% CI) for SCD comparing men with multimorbidity vs no multimorbidity was 1.97 (95% CI, 1.54 to 2.51). Compared with men with no multimorbidity, the corresponding adjusted HRs (95% CIs) for SCD were 1.93 (95% CI, 1.50 to 2.47) for men with two to three conditions and 2.66 (95% CI, 1.34 to 5.28) for men with four to five conditions. In middle-aged and older men, multimorbidity is strongly linked to an increased risk of SCD, independent of known cardiovascular risk factors. Furthermore, the risk of SCD rises progressively with the number of coexisting health conditions.