The growing prevalence of cardiometabolic multiple long-term conditions—the coexistence of two or more diseases such as diabetes, cardiovascular disease, and chronic kidney disease—represents one of the defining challenges for global health systems, according to a new Lancet series. The research highlights that these conditions arise from a complex interplay of biological, sociodemographic, environmental, and behavioural factors across the life course.
Progress in understanding cardiometabolic MLTC has been hampered by substantial heterogeneity in definitions, measurements, and analytical approaches, restricting comparability across studies. These limitations have prompted calls to shift focus toward narrower, more tractable clusters of conditions that disproportionately affect outcomes like mortality and quality of life.
Shared risk factors and mechanisms—including insulin resistance, adiposity, and chronic inflammation—underpin the development of these conditions. Growing evidence also implicates that even low-level, long-term exposure to fine particulate matter and nitrogen dioxide can accelerate the disease trajectory.
Interventions for prevention and management span population-level, individual-level, and system-level approaches, with similar therapeutic strategies showing positive effects across many constituent conditions. Grouping these diseases is justified because aetiological antecedents and risk factors are often shared.
Some experts caution that narrowing the focus may risk overlooking patients with less common multimorbidity combinations, potentially exacerbating health inequities for those whose disease clusters fall outside prioritised categories.