Comorbidity in cardiovascular disease: a widespread phenomenon

Why is this important?

Improved primary prevention by lifestyle changes and pharmacological treatment of cardiovascular risk factors have resulted in a lower risk of cardiovascular events and a spectacular drop in cardiovascular mortality in the last decades. As a result, the age at which people have their first cardiovascular event has shifted to older age and patients live longer after the onset of cardiovascular disease also as a result of effective revascularisation procedures.What’s more, the life expectancy of patients with several other chronic diseases, for example certain types of cancer, has increased, leading to an increasing number of patients with a disease that now reach an age where they are at risk to suffer from a cardiovascular event. Taken together, an increasing number of people have more time to ‘accumulate’ combinations of diseases and (new) cardiovascular diseases in their life. Having another disease next to an index disease is called comorbidity. In this thesis we examined comorbidity in patients with cardiovascular disease.

Outline thesis

First, we identified chronic disease combinations and clusters of chronic diseases in patients with cardiovascular disease in the general population, primary health care and secondary health care. Second, we investigated the possible relationship between treatment for breast cancer and subsequent cardiovascular disease. Lastly, we evaluate the consequences of comorbidity investigating comorbidity in relation to the number of chronic medications prescribed as well as the perceived quality of life of patients with cardiovascular disease and comorbidity.