• S Parsons, J McBeth, G J Macfarlane, P C Hannaford, and D P M Symmons.
• Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, UK.
• Eur J Pain. 2015 Feb 1; 19 (2): 167-75.

BackgroundPrevious studies have found an association between chronic pain and cardiovascular (CV) mortality.ObjectiveTo explore the relationship between the severity of pain and non-fatal CV disease.MethodsA 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.ResultsOf 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).ConclusionA 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.© 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFICC®.

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