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Chronic pain carries heightened risk of major adverse cardiac and cerebrovascular events

30 May 2020

Patients with chronic pain are at increased risk of developing major adverse cardiac and cerebrovascular events (MACCEs), according to a study.

The analysis included 17,614 chronic pain patients aged <65 years from the Taiwan National Health Insurance Research Database and 35,228 matched controls. The average age of the entire population was 50 years, and the majority were female (55.5 percent).

Common causes of chronic pain were spinal disorders (23.9 percent), osteoarthritis (12.4 percent), headaches (11.0 percent), gout (10.2 percent), malignancy (6.2 percent), and osteoporosis (4.5 percent). Participants with vs without chronic pain had a higher prevalence of comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, and depression.

On multivariable Cox proportional hazard regression analyses, chronic pain was associated with an elevated risk of MACCE (adjusted hazard ratio [AHR], 1.3, 95 percent confidence interval [CI], 1.3–1.4). Subgroup analyses further revealed a risk increase for all-cause mortality (AHR, 1.4, 95 percent CI, 1.1–1.8), acute myocardial infarction (AHR, 1.2, 95 percent CI, 1.0–1.4), and stroke (AHR, 1.3, 95 percent CI, 1.3–1.4).

According to researchers, the excess risk of MACCE in individuals with chronic pain may be attributed to stress-related endocrine and sympathetic responses, as well as reduced activity and mood alternations.

The findings underscore the importance of early detection and treatment of chronic pain, as well as management of its causes and underlying comorbidities, they added.

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