Multimorbidity as a driver of heart diseases risk among low socioeconomic older adults population in India

Within the spectrum of non-communicable diseases (NCDs), the burden among older adults in India is predominantly driven by degenerative diseases and conditions. Over the past decade, this burden exhibited a cascading effect, increasingly manifesting as the mounting prevalence of multimorbidity. The study estimated that over half of the adult population aged 45 years and above (50.94%) experienced multimorbidity. A pronounced and accelerating prevalence of multimorbidity gradient of up to four to six diseases/conditions was evident in the 45-84 years age groups, and the highest prevalence of 26% was observed in those aged 80 years and above. Among all diseases and conditions, hypertension emerged as the most prevalent condition, affecting 26.72% of older adults. Furthermore, the disease network analysis identified hypertension, followed by eye conditions and gastrointestinal conditions, as the most central and interconnected condition in multimorbidity framework. Notably, hypertension, high cholesterol, and obesity exhibited significant perilous linkages with life-threatening diseases such as heart diseases. The Classification and Regression Tree (CART) model further reveals thathigh cholesterol together with prolonged hypertension significantly elevated the risk of heart diseases. Importantly, this risk was not solely driven by the co-occurrence of diseases and conditions; it was significantly intensified among socioeconomically disadvantaged individuals in the Indian population.