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of HF patients aged 65 or older, had ≥5 comorbidities, ≥70% had 3 comorbidities, and only 4% had no comorbidities at all.2 These findings suggest that considerable attention should be paid toward designing treatment and care for patients with multiple comorbidities. More importantly, with the increasing number of comorbidities, cardiovascular patients had lower rates of labor force participation, lower incomes, lower amount of tax being paid, and higher amounts of government transfer income,1 which indicates that comorbidities make patients more financially vulnerable and lead to loss of productivity. Comorbidities do not only cause a reduction in the actual work force, but also lead to a reduction in work hours for patients and increased early retirement. Given the economic impact of the rapid aging of the population and lower birth rates than in the past, an efficient societal system to secure and promote workforce participation for patients with multiple comorbidities is necessary. In addition to the aforementioned consequences for society, comorbidity also has a considerable impact on the personal economy and welfare of patients and their families, and may lead to poor health outcomes. A study of 29,620 patients hospitalized n an era of increasing economic concern and increasing burden of chronic disease, studies on the economic impact of cardiovascular disease (CVD) and comorbidity are extremely important. In this issue of the Journal, Schofield et al demonstrate that multiple comorbidities are common among cardiovascular patients, and the number of morbidities is negatively associated with economic productivity such as labor force participation, incomes and amount of tax being paid.1 Depression was one of the most important comorbidities that strongly influenced labor force participation in patients with CVD.

Impact of Comorbidities on Economic and Health Outcomes for Patients With Cardiovascular Disease