Olsen Roy Bjørkholt, Bruehl Stephen, Nielsen Christopher Sivert, Rosseland Leiv Arne, Eggen Anne Elise, Stubhaug Audun
Division of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway,
J Behav Med. 2014 Dec;37(6):1193-201. doi: 10.1007/s10865-014-9568-3. Epub 2014 May 3.
We tested whether cardiovascular stress responsiveness is elevated in individuals experiencing chronic pain in a large general population sample. Blood pressure (BP) and heart rate (HR) were assessed at rest, during the cold pressor test, and during subsequent recovery in 554 individuals reporting daily chronic pain and 3,082 individuals free of chronic pain. After correcting for potential confounds, differences as a function of chronic pain status were noted for only 5 of 23 cardiovascular outcomes despite very high statistical power. Compared to the pain-free group, the chronic pain group displayed higher baseline HR/mean arterial pressure (MAP) ratio (p = .03), greater systolic BP (SBP) reactivity during the cold pressor test (p = .04), and higher HR/MAP ratio (p = .047) and significantly less SBP (p = .017) and MAP (p = .041) return to baseline during recovery. Findings suggest that changes in cardiovascular stress responsiveness associated with chronic pain are of limited clinical significance and unlikely to contribute to increased cardiovascular risk in the chronic pain population.
我们在一个大型普通人群样本中测试了慢性疼痛个体的心血管应激反应性是否升高。对554名报告每日存在慢性疼痛的个体和3082名无慢性疼痛的个体在静息状态、冷加压试验期间以及随后的恢复过程中评估了血压（BP）和心率（HR）。在对潜在混杂因素进行校正后，尽管统计效能非常高，但在23项心血管指标中，仅5项指标存在与慢性疼痛状态相关的差异。与无疼痛组相比，慢性疼痛组表现出更高的基线心率/平均动脉压（MAP）比值（p = 0.03）、冷加压试验期间更高的收缩压（SBP）反应性（p = 0.04）、更高的心率/MAP比值（p = 0.047），且在恢复过程中收缩压（p = 0.017）和平均动脉压（p = 0.041）回到基线的幅度明显更小。研究结果表明，与慢性疼痛相关的心血管应激反应性变化具有有限的临床意义，不太可能导致慢性疼痛人群心血管风险增加。
