• Kun-Ming Chung, Chung-Han Ho, Yi-Chen Chen, Chien-Chin Hsu, Chong-Chi Chiu, Hung-Jung Lin, Jhi-Joung Wang, and Chien-Cheng Huang.
• Division of General Internal Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
• Pain Med. 2020 Sep 1; 21 (9): 1985-1990.

ObjectiveChronic pain (CP) may increase the risk for major adverse cardiac and cerebrovascular events (MACCEs); however, this issue is still unclear in the Asian population. We conducted this study to delineate it.DesignFrom the Taiwan National Health Insurance Research Database, we identified 17,614 participants (<65 years) with CP and matched them by age and sex at a 1:2 ratio to participants without CP, who made up the comparison cohort. Several causes of CP and its underlying comorbidities were also analyzed.Outcome MeasureA comparison of MACCE occurring in the two cohorts was performed via follow-up until 2015.ResultsThe mean age (SD) was 50.2 (11.5) years and 50.4 (11.7) years in participants with and without CP, respectively. In both cohorts, the percentage of female participants was 55.5%. Common causes of CP were spinal disorders (23.9%), osteoarthritis (12.4%), headaches (11.0%), gout (10.2%), malignancy (6.2%), and osteoporosis (4.5%). After adjusting for hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, dementia, and depression, participants with CP had a higher risk for MACCE than those without CP (adjusted hazard ratio [AHR] = 1.3, 95% confidence interval [CI] = 1.3 - 1.4). After conducting subgroup analyses, an increased risk was also found for all-cause mortality (AHR = 1.4, 95% CI = 1.1 - 1.8), acute myocardial infarction (AHR = 1.2, 95% CI = 1.0 - 1.4), and stroke (AHR = 1.3, 95% CI = 1.3 - 1.4).ConclusionsCP is associated with increased occurrence of MACCE. Early detection and interventions for CP are suggested.© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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