Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia

doi:10.1093/pm/pnaa107

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Title:	Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia
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
Contributors:	Chi Mei Med Ctr, Dept Internal Med, Div Gen Internal Med Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Emergency Med Southern Taiwan Univ Sci & Technol, Dept Biotechnol Chi Mei Med Ctr, Dept Gen Surg Southern Taiwan Univ Sci & Technol, Dept Elect Engn Taipei Med Univ, Dept Emergency Med Southern Taiwan Univ Sci & Technol, Dept Senior Serv Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth
Keywords:	Asian Cardiac Cerebrovascular Chronic Pain Death Mortality
Date:	2020
Issue Date:	2022-11-18 11:24:04 (UTC+8)
Publisher:	Oxford Univ Press
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.
Relation:	Pain Medicine, v.21, n.9, pp.6
Appears in Collections:	[Dept. of Recreation and Health-Care Management] Periodical Articles

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