Artikel
From pain to destiny: association of widespread pain with cardiovascular mortality
Suche in Medline nach
Autoren
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Jonas Tesarz
- Universitätsklinikum Heidelberg, Allgemeine Innere Medizin & Psychosomatik, Heidelberg
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Wolfgang Eich
- Universitätsklinikum Heidelberg, Innere Medizin II, Heidelberg
| Veröffentlicht: | 5. Februar 2019 |
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Gliederung
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Background: Nascent research has reported etiological associations of widespread pain and cardiovascular disease. However, studies on mortality risk in individuals with widespread pain (WSP) have reported inconsistent results. This study investigated whether there is increased mortality in individuals who report WSP, and establish potential determinants of mortality risk. Therefore, we evaluated the population-based prospective cohort of the Framingham Heart Study (FHS).
Methods: The FHS is a longitudinal multi-generational study. Pain status was assessed between 1990–1994. Cox proportional hazards modelling was used to estimate hazard ratios of WSP on all-cause mortality controlling for sex and age, cardiovascular risk factors, cancer history and lifestyle factors and current medication. WSP examination was carried out in 4746 participants of the FHS (60.3±13.5 years, 55.1% women).
Results: A total of 678 (14.5%) subjects fulfilled the criteria for WSP (WSP-group), whereas 4011 (85.5%) subjects did not. The average follow-up time was 15 years, during which 202 persons died in the WSP group and 1144 in the no-WSP-group. When adjusting for age and sex, all-cause mortality was increased by about 16% in WSP subjects. Individuals with WSP had an increased hazard ratio particularly for cardiovascular cause of death (hazard ratio adjusted by age and sex = 1.46 (95% CI: 1.10–1.94).
Conclusion: Our data show that in a large population-based cohort, WSP is associated with increased hazard ratio for cardiovascular cause of death, underlining the need for pain assessments in cardiovascular practice.
