The long-term effects of cardiometabolic risk factors on mortality and life expectancy: evidence from a health check-up cohort study

OBJECTIVE: Cardiometabolic risk factors significantly contribute to disease burden. This study explored the effects of hypertension (HTN), diabetes mellitus (DM), and hyperlipidemia (HLP) on mortality. It stratified findings by age group and comorbidity severity using the Charlson Comorbidity Index (CCI) score. Additionally, it assessed the compounded effects of comorbid conditions to estimate life expectancy (LE) and years of life lost (YLL) in individuals with various cardiometabolic risk factor combinations. METHODS: Using data from the MJ Health Check-up Database (2002-2017), linked with the National Health Insurance Research Database (2000-2017) and the Death Registry (2002-2019), this study employed Cox proportional hazards models to determine mortality risk associated with various cardiometabolic risk factors. Adjusted Kaplan-Meier curves were constructed to evaluate survival rates across different risk factors and CCI scores. Survival rates were extrapolated to estimate confounder-adjusted LE and YLL for age-comorbidity combinations. RESULTS: Among the three age groups (20-39, 40-59, 60-79), HLP was the most common single risk factor, followed by HTN. In participants with dual risk factors, HTN and HLP were the most frequent pair, with diabetes and HLP second. An increased number of cardiometabolic risk factors elevated mortality risk, particularly in the 20-39 age group. LE, adjusted for confounders, declined with age, higher CCI scores, and more risk factors. YLL decreased with age but increased with higher CCI scores and more risk factors. CONCLUSIONS: Promoting health awareness, early disease detection, and timely medical access can reduce cardiometabolic risk factors and associated comorbidities, thereby alleviating disease burden.