Parsons S, McBeth J, Macfarlane G J, Hannaford P C, Symmons D P M
Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, UK.
Eur J Pain. 2015 Feb;19(2):167-75. doi: 10.1002/ejp.533. Epub 2014 May 28.
Previous studies have found an association between chronic pain and cardiovascular (CV) mortality.
To explore the relationship between the severity of pain and non-fatal CV disease.
A total of 45,994 adults randomly selected from general practice registers in Manchester and Aberdeen were posted a survey, which included a Chronic Pain Grade questionnaire, pain manikin and questions about lifestyle and medical history. A single component measuring pain severity was extracted using factor analysis. Logistic regression was used to test for an association between quintiles of pain severity and a history of CV disease, adjusting for confounders.
Of the 15,288 responders, 61% (n = 9357) reported pain for ≥ 1 day in the past month. Compared with the first (lowest) pain severity quintile, the fully adjusted odds ratio for heart attack in the second severity quintile was 1.25 (95% confidence interval 0.68, 2.30); third quintile: 1.65 (0.93, 2.94); fourth quintile: 1.76 (1.00, 3.11) and fifth (highest) quintile 2.47 (1.43, 4.28). Corresponding figures for angina (excluding heart attack) were: 1.79 (0.93, 3.45), 1.91 (1.00, 3.62), 1.03 (0.50, 2.11) and 3.17 (1.71, 5.85).
A history of CV disease is reported more often in those with severe pain than would be expected by chance, even when adjusting for shared risk factors.
先前的研究发现慢性疼痛与心血管（CV）死亡率之间存在关联。
探讨疼痛严重程度与非致命性心血管疾病之间的关系。
从曼彻斯特和阿伯丁的普通执业登记册中随机抽取45994名成年人，向他们发放一份调查问卷，其中包括慢性疼痛分级问卷、疼痛模拟图以及关于生活方式和病史的问题。使用因子分析提取一个衡量疼痛严重程度的单一成分。采用逻辑回归分析来检验疼痛严重程度五分位数与心血管疾病史之间的关联，并对混杂因素进行校正。
在15288名应答者中，61%（n = 9357）报告在过去一个月中疼痛持续≥1天。与第一个（最低）疼痛严重程度五分位数相比，第二个严重程度五分位数中心脏病发作的完全校正比值比为1.25（95%置信区间0.68，2.30）；第三个五分位数：1.65（0.93，2.94）；第四个五分位数：1.76（1.00，3.11）；第五个（最高）五分位数：2.47（1.43，4.28）。心绞痛（不包括心脏病发作）的相应数字为：1.79（0.93，3.45），1.91（1.00，3.62），1.03（0.50，2.11）和3.17（1.71，5.85）。
即使校正了共同的危险因素，严重疼痛患者报告心血管疾病史的频率也高于偶然预期。
