Sc28.02 Cross-Sectional Associations Between Cardiovascular Disease And Osteoarthritis Comorbidity And Physical Health In General Practice Populations: Co-Morbidity Cohort (2C) Study

Conference: 
Author(s): 
J. A. Prior, K. P. Jordan, U. T. Kadam;
Arthritis Research UK Primary Care Centre, Keele University, United Kingdom.
James A Prior
Keele University
Newcastle-under-Lyme
United Kingdom
Email: j.a.prior@cphc.keele.ac.uk
Phone: +441782734847
Text: 
Background: Increasingly ageing European populations means more patients are experiencing both cardiovascular disease (CVD) and osteoarthritis (OA) at the same time (comorbidity). A cohort study was designed to investigate the impact of combined CVD and OA comorbidity on the physical health of general practice populations.
Methods: The Co-morbidity Cohort (2C) study was conducted in the UK general practice population aged 40 years and over. A baseline survey was mailed to patients from ten general practices, who had consulted for CVD (severity defined as hypertension, ischaemic heart disease (IHD) or heart failure (HF)) or OA in the three years before baseline. The study population were categorised into 8 disease cohorts, patients with: 1) no CVD or OA, 2) hypertension but no OA, 3) IHD but no OA, 4) HF but no OA, 5) OA but no CVD, 6) hypertension & OA, 7) IHD & OA or 8) HF & OA. Physical health was measured using the Physical Component Summary (PCS) score from the Short-Form-12 (SF-12) survey. Cross-sectional associations between cohorts and physical health were assessed using linear regression analysis, adjusting for age, gender and deprivation.
Results: 5,176 patients responded to the baseline survey and completed the SF-12. In comparison to the patients with no CVD or OA, PCS scores decreased (worsening physical health) across all cohorts. For cohorts with individual disease, adjusted mean differences in PCS scores compared to the no CVD or OA group ranged from; -3.63 (95%CI -4.7,-2.5) for those with hypertension but no OA, -8.23 (-9.2,-7.2) for those with IHD but no OA, -14.13 (-16.1,-12.1) for those with HF but no OA to -8.63 (-9.7,-7.6) for those with OA but no CVD. In the co-morbid cohorts this ranged from; -11.07 (-12.1,-10.0) for hypertension & OA, -13.90 (-15.4,-12.4) for IHD & OA to -16.80 (-20.3,-13.3) for HF & OA.
Conclusions: Increasing severity of CVD was associated with poorer physical health. The co-morbid addition of OA increased the strength of association between CVD severity and poor physical health. Disease severity and comorbidity are both important physical health influences, and management and treatment models need to be developed to address these.
Literature: 
SC28.02
Cross-sectional associations between cardiovascular disease and osteoarthritis comorbidity and physical health in general practice populations: Co-morbidity Cohort (2C) study