Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, Staffordshire, UK.
Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, South Yorkshire, UK.
Prim Health Care Res Dev. 2024 Apr 8;25:e15. doi: 10.1017/S1463423624000070.
Chronic musculoskeletal pain and anxiety/depression are significant public health problems. We hypothesised that adults with both conditions constitute a group at especially high risk of future cardiovascular health outcomes.
To determine whether having comorbid chronic musculoskeletal pain and anxiety/depression is associated with the excess prevalence of selected known cardiovascular health risk behaviours.
A cross-sectional survey of adults aged 35+ years randomly sampled from 26 GP practice registers in West Midlands, England. Respondents were classified into four groups based on self-reported presence/absence of chronic musculoskeletal pain (pain present on most days for six months) and anxiety or depression (Hospital Anxiety and Depression Score 11+). Standardised binomial models were used to estimate standardised prevalence ratios and prevalence differences between the four groups in self-reported obesity, tobacco smoking, physical inactivity, and unhealthy alcohol consumption after controlling for age, sex, ethnicity, deprivation, employment status and educational attainment. The excess prevalence of each risk factor in the group with chronic musculoskeletal pain-anxiety/depression comorbidity was estimated.
Totally, 14 519 respondents were included, of whom 1329 (9%) reported comorbid chronic musculoskeletal pain-anxiety/depression, 3612 (25%) chronic musculoskeletal pain only, 964 (7%) anxiety or depression only, and 8614 (59%) neither. Those with comorbid chronic musculoskeletal pain-anxiety/depression had the highest crude prevalence of obesity (41%), smoking (16%) and physical inactivity (83%) but the lowest for unhealthy alcohol consumption (18%). After controlling for covariates, the standardised prevalence ratios and differences for the comorbid group compared with those with neither chronic musculoskeletal pain nor anxiety/depression were as follows: current smoking [1.86 (95% CI 1.58, 2.18); 6.8%], obesity [1.93 (1.76, 2.10); 18.9%], physical inactivity [1.21 (1.17, 1.24); 14.3%] and unhealthy alcohol consumption [0.81 (0.71, 0.92); -5.0%]. The standardised prevalences of smoking and obesity in the comorbid group exceeded those expected from simple additive interaction.
慢性肌肉骨骼疼痛和焦虑/抑郁是重大的公共卫生问题。我们假设同时患有这两种疾病的成年人面临未来心血管健康结果的风险特别高。
确定同时患有慢性肌肉骨骼疼痛和焦虑/抑郁是否与某些已知的心血管健康风险行为的高发率有关。
对随机抽取的英格兰西米德兰兹 26 个全科医生登记处的 35 岁及以上成年人进行横断面调查。根据自我报告的慢性肌肉骨骼疼痛（疼痛持续存在 6 个月，大多数日子都有）和焦虑或抑郁（医院焦虑和抑郁量表 11+）的存在/不存在情况，将受访者分为四组。在控制年龄、性别、种族、贫困程度、就业状况和教育程度后，使用标准化二项式模型估计四组中自我报告的肥胖、吸烟、身体活动不足和不健康饮酒的标准化患病率比和患病率差异。估计慢性肌肉骨骼疼痛-焦虑/抑郁共病组中每种风险因素的过度患病率。
共纳入 14519 名受访者，其中 1329 名（9%）报告同时患有慢性肌肉骨骼疼痛-焦虑/抑郁，3612 名（25%）患有慢性肌肉骨骼疼痛，964 名（7%）患有焦虑或抑郁，8614 名（59%）既无慢性肌肉骨骼疼痛也无焦虑/抑郁。同时患有慢性肌肉骨骼疼痛-焦虑/抑郁的患者肥胖（41%）、吸烟（16%）和身体活动不足（83%）的粗患病率最高，但不健康饮酒（18%）的患病率最低。在控制协变量后，与既无慢性肌肉骨骼疼痛也无焦虑/抑郁的患者相比，共病组的标准化患病率比和差异如下：当前吸烟[1.86（95%CI 1.58, 2.18）；6.8%]、肥胖[1.93（1.76, 2.10）；18.9%]、身体活动不足[1.21（1.17, 1.24）；14.3%]和不健康饮酒[0.81（0.71, 0.92）；-5.0%]。共病组中吸烟和肥胖的标准化患病率超过了简单相加交互作用的预期值。
