Pain in the body, harm to the heart: advances in research on the impact of chronic pain on cardiovascular diseases.

Chronic pain (CP) is highly prevalent, and a substantial proportion of patients concurrently suffer from cardiovascular diseases (CVD), suggesting a complex interplay between these two conditions. CP increases the risk of CVD through multiple mechanisms, including sympathetic overactivation, neuroimmune inflammatory responses, endocrine and metabolic dysregulation, and bidirectional regulation along the heart-brain axis. Moreover, pharmacological treatments traditionally used for CP, such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids and related agents, are associated with heightened cardiovascular risks. In contrast, non-pharmacological interventions like spinal cord stimulation and cognitive behavioral therapy have demonstrated dual potential in alleviating pain and improving cardiovascular outcomes. There is an urgent need to focus on the comorbid mechanisms linking CP and CVD, to develop precise and individualized intervention strategies, and to integrate pain management into cardiovascular prevention and treatment frameworks, thereby optimizing interdisciplinary approaches to comorbidity prevention and care.