Objective To investigate the current comorbidity situation of hypertension, diabetes, and dyslipidemia and infulencing factors in adults of Fujian province, and to provide a scientific basis for "co-management of the three diseases".

Methods Based on the Fujian Province data from the "China Residents Cardiovascular Disease and Risk Factors Surveillance Project (2020)", a multi-stage stratified random sampling method was used to select 9 666 residents aged ≥18 years as the survey subjects. Data were collected through questionnaires (demographics, lifestyle and behaviors, disease history, and medication history), physical examinations (height, weight, body fat, waist circumference, blood pressure), and laboratory tests (fasting blood glucose, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol). Chi-square or trend chi-square tests were used to analyze the differences in comorbidities among people with different characteristics, and multivariate unordered multinomial logistic regression analysis was applied to identify influencing factors of comorbidity status of hypertension, diabetes, and dyslipidemia.

Results The age-standardized prevalences of hypertension, diabetes, and dyslipidemia were 34.6%, 7.3%, and 31.7%, respectively. Among the comorbidity patterns of two and three diseases, the prevalence of hypertension combined with dyslipidemia was the highest (standardized prevalence was 12.7%). The standardized prevalences of three diseases and hypertension combined with diabetes were 2.9% and 2.0%, respectively. The prevalence of diabetes combined with dyslipidemia was the lowest (the standardized prevalence was 1.3%). Multinomial logistic regression analysis showed that male (ORs were 2.173, 2.496 and 2.049, respectively), age (compared with the 18−44 years old group, the ORs for the 45−59 years old group were 2.217, 3.723 and 4.780, and for the ≥60 years old group were 4.773, 10.720 and 23.311, respectively), married/remarried/cohabiting (compared with unmarried, ORs were 1.504, 2.175 and 2.967, respectively), divorced/widowed/separated (compared with unmarried, ORs were 1.757, 2.625 and 3.458, respectively), central obesity (ORs were 1.457, 2.061 and 3.109, respectively), overweight or obese (compared with normal body mass index,ORs for overweight were 1.803, 2.643 and 3.454; ORs for obese were 3.043, 5.048 and 6.752, respectively), and insufficient physical activity (ORs were 1.114, 1.154, and 1.356, respectively) were all positively associated with the comorbidity of 1, 2 and 3 diseases (P＜0.05). In addition, current alcohol drinkers had a higher risk of developing the "three highs", with an OR of 1.465 (P＜0.05).

Conclusions The comorbidity of hypertension, diabetes, and dyslipidemia is common among adults in Fujian Province. It is necessary to strengthen the "co-management of three diseases" in key populations such as male, middle-aged and elderly, married or cohabiting individuals, and those with other marital statuses (divorced, widowed, separated, etc.), as well as those who are overweight, obese, and physically inactive. The multimorbidity management approach should be applied to improve management outcomes.