156607 20251017144634.0 doi 10.3390/jcm14082615 sideral 143868 ART-2025-143868 eng Ioakeim-Skoufa, Ignatios (orcid)0000-0002-6518-749X Charting the Pathways of Cardiometabolic Multimorbidity: A Systematic Review of Clinical Trajectories 2025 Access copy available to the general public Unrestricted Background: Managing multimorbidity is a major challenge for healthcare systems. Cardiometabolic multimorbidity (CMM) is highly prevalent and linked to increased disease burden, functional decline, and mortality. While most studies focus on cross-sectional analyses, longitudinal approaches are essential for understanding disease progression and identifying patient groups who may benefit from targeted interventions. Objectives: This systematic review synthesises evidence from longitudinal studies on the incidence and progression of CMM, exploring transitions between multimorbidity clusters and their clinical implications. Methods: A systematic search was conducted in MEDLINE and EMBASE following PRISMA guidelines. Studies were included if they employed longitudinal designs and clustering techniques to assess multimorbidity evolution. The quality of evidence was evaluated using the GRADE system. Results: Ten studies met the inclusion criteria. CMM occurs across all age groups and both sexes, showing the highest mortality and functional decline rates. Patients with CMM frequently develop additional cardiometabolic conditions or transition to related clusters. Many also experience neurodegenerative and mental health disorders. Individuals from respiratory multimorbidity clusters often transition to CMM. Moreover, CMM is more prevalent in lower socioeconomic populations. Conclusions: Understanding multimorbidity trajectories enables targeted preventive strategies. Identifying patients with predictable progression can help design adequate and effective interventions, reduce health disparities, and improve healthcare outcomes. info:eu-repo/grantAgreement/ES/DGA-FEDER/B01-20R info:eu-repo/grantAgreement/ES/ISCIII/RD24-0005-0013 info:eu-repo/grantAgreement/ES/ISCIII-RICAPPS/RD21-0016-0019 info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Ledesma-Calvo, Rubén Moreno-Juste, Aida Roque, Fátima Atkins, Kerry Hernández-Rodríguez, Miguel Ángel Aza-Pascual-Salcedo, Mercedes González-Rubio, Francisca Lasala-Aza, Carmen Esteban-Jiménez, Óscar Avedillo-Salas, Ana Universidad de Zaragoza (orcid)0000-0003-2153-0417 Cebollada-Herrera, Celeste Gimeno-Miguel, Antonio (orcid)0000-0002-5440-1710 Vicente-Romero, Jorge Universidad de Zaragoza (orcid)0000-0003-4629-6743 1012 315 Universidad de Zaragoza Dpto. Farmac.Fisiol.y Med.L.F. Área Farmacología 14, 8 (2025), 2615 [15 pp.] J. clin.med. Journal of Clinical Medicine 2077-0383 534598 http://zaguan.unizar.es/record/156607/files/texto_completo.pdf Versión publicada 2804075 http://zaguan.unizar.es/record/156607/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:156607 articulos driver 2025-10-17-14:27:57 ARTICLE