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What is comorbidity and why is it important?

More than 15 million people – that’s 30% of the UK population – live with one or more long term condition.

COVID has brought many things to our attention, one of which is how impermanent life is.   Modern medicine aims to keep us alive, and we have all been shocked and scared with the daily death toll reported in the media. The reality is – we are going to die. The question to consider is, how? Part of the answer to that is going to include the quality of our health. 

Generally, we are born healthy. As, and how, we go through life, often dictates what disease(s) we may or may not get during our life time.

Morbidity is the state of being sick or having a disease.

Comorbidity is the state of having multiple medical conditions at the same time.

When there is an overlap of different conditions, they can impact on each other. This generally means that the person will become more ill more quickly and it will take longer for treatment to work and to then recover.

We see this in hospitals, where you go in with one thing and whilst there get something else – for example hospital-acquired pneumonia.

Illnesses can be physical: for example diabetes comorbid with hypertension (high blood pressure) or mental and depression is often comorbid with anxiety.

We have seen with COVID, that those people who already have underlying health issues are more at risk of COVID and are then getting more serious symptoms.

Comorbidity can be difficult to treat, because of the question of which illness to treat? When the treatment is the prescription of medication (which it generally is with modern medicine) this is made even more difficult. This is because as the illnesses can impact on each other, the treatment for one may cause unintended effects on the other. For example, can a person taking migraine medication also take anti-depression medication?

Comorbidity can also increase the risk for other disease. For example, people who have both diabetes and high blood pressure are at an increased risk for cardiovascular disease, that is, anything that affects the heart and blood vessels. 

It is really important to remember that, just because two conditions are occurring at the same time together, it doesn’t mean that one is causing the other, or that they are caused by the same thing.  So you can have two separate conditions with two separate causes.

As we can see, the challenge for medics is what medication to prescribe or surgical interventions to make. The more illnesses or conditions we have the more complicated the chemistry and the side-effects.  We all know this one – suffering pain/inflammation so given anti-inflammatories which stop the production of the mucous which protects the stomach lining,  leading to the prescription of antacid medication which then leads to the intrinsic factor not being produced which leads to Vitamin B12 deficiency.

The truth is that many of the illnesses we have are preventable; they are the result of our lifestyle. What is happening in my life that my body’s response is to raise my blood pressure, increase the cholesterol levels, to be constipated/have diarrhoea, to have a cough, to be short of breath etc. 

We, and our bodies, are always trying to be balanced. Any imbalance will be seen in symptoms or altered function, which if left untreated will end up in disease.

Maybe now is the time to stop and ask ourselves the question – HOW did I get like this?

This article was written by Karen Robinson, our Clinical Director.