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复杂慢性疾病人群中的高血压性痛觉减退

Hypertensive Hypoalgesia in a Complex Chronic Disease Population.

作者信息

Ferguson Meaghan, Slepian Maxwell, France Christopher, Svendrovski Anton, Katz Joel

机构信息

Department of Psychology, York University, Toronto, ON M3J 1P3, Canada.

Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON M3J 1P3, Canada.

出版信息

J Clin Med. 2021 Aug 25;10(17):3816. doi: 10.3390/jcm10173816.

Abstract

Hypertension-related hypoalgesia, defined as lower pain sensitivity in individuals with high blood pressure, has yet to be examined in a large-scale study of complex care residents. Here, the Continuing Care Reporting System database, which contains health information on residents of Canadian complex chronic care facilities, was used for assessment. Hypertension was reported among 77,323 residents (55.5%, total = 139,920). Propensity score matching, with a 1:1 ratio, was used to identify a control record without hypertension for each case. Multinomial logistic regression was used to quantify the effects of hypertension and sex on four-level ordinal pain variables, controlling for potential confounders. The matched dataset included = 40,799 cases with hypertension and = 40,799 without hypertension, with 57% female. Residents with hypertension had significantly lower odds of reporting pain (yes/no) ( = 0.85, 95% CI 0.81-0.90, < 0.001), including on measures of severe pain ( = 0.69, 95% CI 0.63-0.76, < 0.001). A significant interaction between hypertension and sex ( = 1.17, 95% CI 1.03-1.32, = 0.014) indicated that a significantly greater proportion of females without hypertension reported severe pain (8.71%). The results confirm the relationship between hypertension and reduced pain sensitivity on a population level.

摘要

高血压相关的痛觉减退,定义为高血压患者疼痛敏感性较低,尚未在复杂护理居民的大规模研究中进行考察。在此,使用了包含加拿大复杂慢性护理机构居民健康信息的持续护理报告系统数据库进行评估。在139,920名居民中,有77,323名(55.5%)报告患有高血压。采用倾向得分匹配法,以1:1的比例,为每个病例确定一个无高血压的对照记录。使用多项逻辑回归来量化高血压和性别对四级有序疼痛变量的影响,并控制潜在的混杂因素。匹配后的数据集包括40,799例高血压患者和40,799例无高血压患者,其中57%为女性。患有高血压的居民报告疼痛(是/否)的几率显著较低(比值比 = 0.85,95%置信区间0.81 - 0.90,P < 0.001),包括在严重疼痛测量方面(比值比 = 0.69,95%置信区间0.63 - 0.76,P < 0.001)。高血压与性别之间存在显著交互作用(比值比 = 1.17,95%置信区间1.03 - 1.32,P = 0.014),表明无高血压的女性中报告严重疼痛的比例显著更高(8.71%)。结果证实了在人群水平上高血压与疼痛敏感性降低之间的关系。

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Sex Differences in Pain.疼痛中的性别差异
J Neurosci Res. 2017 Jun;95(6):1271-1281. doi: 10.1002/jnr.23841. Epub 2016 Jul 25.
4
The relationship between blood pressure and pain.血压与疼痛之间的关系。
J Clin Hypertens (Greenwich). 2013 Aug;15(8):600-5. doi: 10.1111/jch.12145. Epub 2013 Jun 10.
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When does acute pain become chronic?急性疼痛何时转为慢性?
Br J Anaesth. 2010 Dec;105 Suppl 1:i69-85. doi: 10.1093/bja/aeq323.

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