Chronic co-morbid conditions and the risk of cardiovascular disease

Co-morbidities are health conditions that co-occur with an index condition of interest. They are known to contribute to health outcomes directly, as potential confounders or as effect modifiers. However, these relationships are not well understood. Understanding how co-morbidities mediate the risk of cardiovascular disease is of vital importance as single disease approaches are unable to appropriately guide treatment options. Furthermore, patients with chronic co-morbidities are believed to receive poorer quality of care. Whilst there are several validated frameworks available to measure quality of care, further work needs to be done to identify key performance indicators that take a more holistic view of clinical needs, for example, including weights for patient adherence, likelihood of benefit and patient complexity. Understanding co-morbidities is one of the most important issues facing health systems in developed countries today.

This project uses a national primary care database of over 15 million patients (Clinical Practice Research Datalink (CPRD) linked with inpatient/outpatient data in secondary care (Hospital Episode Statistics (HES)) to assess the patterns of associations between chronic co-morbid conditions and cardiovascular disease. Specific aims are to:  

  1. Detail the associations between chronic co-morbidities and cardiovascular disease
  2. Develop and validate a novel risk prediction model for individuals with chronic co-morbidities, in particular, pre-existing vascular disease
  3. Assess the impact of chronic co- morbidities on the quality of care for patients with cardiovascular disease