title: The association between self-reported cardiovascular disorders and troublesome neck pain: a population-based cohort study.
abstract: OBJECTIVE
  The purpose of this population-based cohort study was to investigate the association between self-reported cardiovascular disorders and troublesome neck pain.
  
  
  METHODS
  Using data from the Saskatchewan Health and Back Pain Survey (1995), we formed a cohort of 922 randomly sampled Saskatchewan adults with no or mild neck pain. We used the Comorbidity Questionnaire to measure the point prevalence of self-reported cardiovascular disorders and classified them into 3 levels of severity: (1) absent, (2) present but does not or mildly impacts on my health, and (3) present and moderately or severely impacts on my health. Six and 12 months later, we measured the presence of troublesome neck pain (grades II-IV) using the Chronic Pain Questionnaire. Multivariable Cox regression was used to estimate the association between cardiovascular disorders and the troublesome neck pain while controlling for confounders.
  
  
  RESULTS
  The follow-up rate was 73.8% (680/922) at 6 months and 62.7% (578/922) at 1 year. No association was found between self-reported cardiovascular disorders that had no or mild impact on health and the onset of troublesome neck pain. We found a crude association between self-reported cardiovascular disorders that moderately or severely impacted health and the onset of troublesome neck pain (crude hazard rate ratio, 4.3; 95% confidence interval, 1.8-10.0). The association was positively confounded by age, sex, and education (adjusted hazard rate ratio, 5.9; 95% confidence interval, 2.3-14.9).
  
  
  CONCLUSIONS
  Our analysis suggests that self-reported cardiovascular disorders that moderately or severely impact one's health are a risk factor for developing troublesome neck pain.
authors.affiliation: Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada. pnolet@rogers.com
authors.forename: Paul S
authors.initials: PS
authors.lastname: Nolet
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: J David
authors.initials: JD
authors.lastname: Cassidy
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Carroll
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019547:Neck Pain / Q000175:diagnosis / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult