Chronic pain -- an underestimated risk factor for cardiovascular disease? Study sheds light
Sweden: A recent study in the European Journal of Preventive Cardiology has demonstrated an association between chronic pain and increased risk for myocardial infarction, heart failure, stroke, and cardiovascular death. This association was independent of established socioeconomic factors, cardiovascular risk factors, co-morbidities, and medication.
The researchers wrote, "Our study is the largest to date to confirm and extend the understanding of chronic pain as an underestimated cardiovascular risk factor having important public health implications."
There is no clear understanding of the interplay between the pain of different chronicity and cardiovascular disease. To shed light on the same, Johan Ärnlöv, Department of Health and Social Studies, Dalarna University, Falun, Sweden, and colleagues aimed to examine the association between different levels of chronic or non-chronic pain and CVD risk.
For this purpose, the researchers divided participants in the UK Biobank who reported pain at baseline into three groups according to pain duration and widespreadness. Controls were the participants reporting no pain. The association between pain and incidence of heart failure, myocardial infarction, stroke, cardiovascular mortality and composite CVD (defined as any of the before-mentioned cardiovascular events) was investigated using Multivariable Cox regression.
Salient findings of the study include:
- Of 475,171 participants, 189,289 reported no pain, 87,830 reported short-term pain, 191,716 chronic localized pain, and 6,336 chronic widespread pain (CWP).
- During a median of 7.0 years' follow-up, participants with CWP and chronic localized pain had, after adjustment for age, sex, established cardiovascular risk factors, physical activity, anxiety, depression, cancer, chronic inflammatory/painful disease, pain/anti-inflammatory medication, socioeconomic status, a significantly increased risk for composite CVD (hazard ratio, HR 1.14 and HR 1.48 respectively) compared to controls, with similar results when using the different specific CVDs as outcomes.
- Population attributable risk proportion for chronic pain as a risk factor for composite CVD was comparable to that of diabetes (8.6% vs. 7.3%, respectively).
The researchers concluded the study by saying that, "Our study, the largest to date, confirms and extends our understanding of chronic pain as an underestimated cardiovascular risk factor with important public health implications."
Reference:
Ann Sofie Rönnegård, Christoph Nowak, Björn Äng, Johan Ärnlöv, The association between short-term, chronic localized and chronic widespread pain and risk for cardiovascular disease in the UK Biobank, European Journal of Preventive Cardiology, 2022;, zwac127, https://doi.org/10.1093/eurjpc/zwac127
