Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia. Issue 9 (7th May 2020)

• Record Type: Journal Article
• Authors: Chung, Kun-Ming; Ho, Chung-Han; Chen, Yi-Chen; Hsu, Chien-Chin; Chiu, Chong-Chi; Lin, Hung-Jung; Wang, Jhi-Joung; Huang, Chien-Cheng
• Is Part Of: Pain medicine. Volume 21:Issue 9(2020)
• Page Start: 1985
• Page End: 1990
• Publication Date: 2020-05-07
• Subjects: Asian -- Cardiac -- Cerebrovascular -- Chronic Pain -- Death -- Mortality; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnaa107
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objective: Chronic pain (CP) may increase the risk for major adverse cardiac and cerebrovascular events (MACCEs); however, this issue is still unclear in the Asian population. We conducted this study to delineate it. Design: From the Taiwan National Health Insurance Research Database, we identified 17, 614 participants (<65 years) with CP and matched them by age and sex at a 1:2 ratio to participants without CP, who made up the comparison cohort. Several causes of CP and its underlying comorbidities were also analyzed. Outcome Measure: A comparison of MACCE occurring in the two cohorts was performed via follow-up until 2015. Results: The mean age (SD) was 50.2 (11.5) years and 50.4 (11.7) years in participants with and without CP, respectively. In both cohorts, the percentage of female participants was 55.5%. Common causes of CP were spinal disorders (23.9%), osteoarthritis (12.4%), headaches (11.0%), gout (10.2%), malignancy (6.2%), and osteoporosis (4.5%). After adjusting for hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, dementia, and depression, participants with CP had a higher risk for MACCE than those without CP (adjusted hazard ratio [AHR] = 1.3, 95% confidence interval [CI] = 1.3 − 1.4). After conducting subgroup analyses, an increased risk was also found for all-cause mortality (AHR = 1.4, 95% CI = 1.1 − 1.8), acute myocardial infarction (AHR = 1.2, 95% CI = 1.0 − 1.4), and stroke (AHR = 1.3, 95% CI = 1.3 − 1.4). Conclusions: CP is associated with increased occurrence of MACCE. Early detection and interventions for CP are suggested.