Multimorbidity Of Non-cardiovascular Chronic Diseases And Related Factors In Hospitalizded Patients With Cardiovascular Diseases

Background-Cardiovascular diseases(CVD)is the most common cause of non-communicable disease deaths worldwide.With the development of medical and health services,CVD patients live longer,but at the same time they also bear the burden of multimorbidity.Multimorbidity is an important cause of the decline in the quality of life,the increase in the use of medical resources and the increase in mortality of CVD patients.Patients with multimorbidity need more drugs for treatment,require communication between disciplines,and there may be therapeutic conflicts between diseases and diseases,use conflicts between drug and drug,and increased adverse drug reactions,which pose enormous challenges for health care providers.The current clinical treatment methods are mainly guided by the clinical practice guidelines for single diseases,and these methods do not adapt well to the challenges posed by CVD patients combining multiple diseases.Therefore,it is urgent to explore the common multimorbidity patterns of CVD patients and develop a more comprehensive diagnosis and treatment plan for specific multimorbidity combinations.In addition,CVD patients with multimorbidity faced greater mental health question.Although the Psycho-cardiology requires clinicians to pay attention to the psychological condition of patients,most doctors in China do not recognize patients’ anxiety and depressive symptoms,resulting in repeated medical treatment and waste of medical resources.Objectives-To study the status quo of non-cardiovascular chronic diseases in hospitalized cardiovascular patients,assessment their psychological condition and analyze the influence factors,to provide a theoretical basis for the prevention and management of multimorbidity and the improvement of quality of life of CVD patients.Methods-Continuous collection of CVD patients admitted to Hebei Provincial People’s Hospital from April 1,2019 to November 30,2020,according to the number of non-cardiovascular chronic diseases divided into a simple CVD group,CVD combined with 1 chronic disease group and CVD combined with 2 or more chronic diseases group,Collect the demographic characteristics of the patient and the results of the relevant laboratory tests for hospitalization.Use the Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9)and Pittsburgh Sleep Quality Index(PSQI)assess patients’ mental state and sleep quality.Statistics are performed through SPSS 26.0,analysis the common pattern of non-cardiovascular chronic diseases with CVD patients,and look for the influence factors of multimorbidity in patients with CVD.Results-A total of 1085 CVD patients were included in this study,including 138 patients with CVD alone,455 cases of CVD patients combined with 1 chronic disease,and 502 cases of CVD patients combined with 2 or more chronic diseases.The most common types of multimorbidity in turn are peripheral artery disease(75.5%),diabetes mellitus(29.9%),stroke(21.8%),anemia(13.2%),chronic kidney disease(5.8%)and chronic obstructive pulmonary disease(4.4%).The top 3common models of CVD patients combined with 2 non-cardiovascular chronic diseases were: CVD + peripheral arterial diseases+ diabetes(49.9%),CVD + peripheral arterial diseases+ stroke(34.4%),CVD +peripheral arterial diseases + anemia(10.0%).Of all patients,35.9 percent had depressive symptoms,25.6 percent had anxiety symptoms,and 53.5percent had poor sleep quality.Multi-factor logistic regression analysis,using simple CVD group as a control group,found that patients in the CVD combined with 1 chronic disease group had higher age(P<0.05),and those in the CVD combined with 2 or more chronic diseases groups had higher age,higher PHQ-9 total score,higher systolic blood pressure,higher fasting plasma glucose and higher creatinine levels,while lower HGB and lower LDL-C levels(P<0.05).Conclusions-The majority(87.3%)of the 1085 hospitalized CVD patients have burden of non-cardiovascular chronic diseases multimorbidity.The types of multimorbidity in turn are peripheral artery disease,diabetes,stroke,anemia,chronic kidney disease,and chronic obstructive pulmonary disease.The top 3 common models of CVD patients combined with 2non-cardiovascular chronic diseases were: CVD + peripheral arterial diseases + diabetes,CVD + peripheral arterial diseases + stroke,CVD +peripheral arterial diseases + anemia.More people with multimorbidity with CVD have depressive symptoms.CVD patients with non-cardiovascular diseases had more older people,more combined depressive symptoms,more depression,higher levels of systolic blood pressure,fasting plasma glucose,and creatinine,and lower levels of hemoglobin and low density lipoprotein cholesterol.