Chronic musculoskeletal pain increases CVD risk

Chronic musculoskeletal pain increases CVD risk

By Lucy Piper, Senior medwireNews Reporter

06 January 2014

Eur J Pain 2013; Advance online publication

medwireNews: Chronic musculoskeletal pain (CMP) is associated with an increased risk for cardiovascular disease (CVD), researchers have found.

They note that this association was particularly strong in adults older than 65 years with CMP, who were 1.83 times more likely than those without CMP to have CVD after taking into account a range of CVD risk factors. Also, the association could not be explained by reduced physical activity or increased sedentary behavior.

Rather, the team suggests that physiologic or psychosocial effects of pain, such as obesity, stress, and increased levels of pro-inflammatory cytokines, may be involved.

“Clinically, this study suggests the intriguing implication that CMP may be a modifiable risk factor for CVD,” note the researchers, led by Cormac Ryan (Teeside University, Middlesborough, UK).

“Considering, on average, 10% of the world’s population report CMP… this could have far reaching implications for CVD prevention giving support to previous calls for CMP to be considered as a public health priority.”

Among 3332 middle-aged (45–64 years) and 2022 older adults, who participated in the Health Survey for England (2008), 18% and 28%, respectively, reported having CMP. And of these individuals, 22.5% and 46.8% had CVD. This compared with a corresponding 13.5% and 28.2% of participants without CMP.

Logistic regression analysis showed that middle-aged adults with CMP were more likely to have CVD than those without, at an odds ratio of 1.27 after taking into account CVD risk factors, such as body mass index, metabolic conditions, and alcohol intake, but unlike in older adults it did not reach statistical significance.

Self-reported, but not objectively measured, physical activity was independently associated with CVD in both middle-aged and older adults. But neither subjectively nor objectively measured physical activity contributed meaningfully to the association between CMP and CVD.

Similarly, while subjectively and objectively measured sedentary behavior was an important risk factor for CVD in older adults, it did not contribute to the association between CMP and CVD in these individuals.

Ryan et al note in the European Journal of Pain that the cross-sectional design of the 2008 Health Survey for England meant that causality and the direction of the relationship between CMP and CVD could not be confirmed.

But they conclude: “If our findings are supported by future large longitudinal studies, this would suggest that the appropriate management of CMP should not simply be viewed as an intervention for CMP in itself but also a preventive… strategy to reduce the risk of developing CVD.”

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