title: Cardiovascular risk factors associated with the metabolic syndrome are more prevalent in people reporting chronic pain: results from a cross-sectional general population study.
abstract: To explore whether chronic pain is associated with cardiovascular risk factors and identify whether increased distribution or intensity of pain is associated with cardiovascular risk, participants in Generation Scotland: The Scottish Family Health study completed pain questionnaires recording the following: presence of chronic pain, distribution of pain, and intensity of chronic pain. Blood pressure, lipids, blood glucose, smoking history, waist-hip ratio, and body mass index were recorded; Framingham 10-year coronary heart disease (CHD) risk scores were calculated and a diagnosis of metabolic syndrome derived. Associations between chronic pain and cardiovascular risk were explored. Of 13,328 participants, 1100 (8.3%) had high CHD risk. Chronic pain was reported by 5209 (39%), 1294 (9.7%) reported widespread chronic pain, and 707 (5.3%) reported high-intensity chronic pain. In age- and gender-adjusted analyses, chronic pain was associated with elevated CHD risk scores (odds ratio 1.11, 95% confidence interval 1.01-1.23) and the metabolic syndrome (odds ratio 1.42, 95% confidence interval 1.24-1.62). Multivariate analyses identified dyslipidaemia, age, gender, smoking, obesity, and high waist-hip ratio as independently associated with chronic pain. Within the chronic pain subgroup, widespread pain did not confer any additional cardiovascular disease risk. However, cardiovascular disease risk factors contributing to metabolic syndrome were more prevalent in those reporting high-intensity chronic pain. This large population-based study has demonstrated that chronic pain, and in particular high-intensity chronic pain, is associated with an increased prevalence of cardiovascular risk factors and metabolic syndrome. The 10-year CHD risk score and metabolic syndrome correlate well with increased pain intensity, but not with widespread pain.
authors.affiliation: Division of Musculoskeletal Biology I, Institute of Ageing and Chronic Disease, Faculty of Health and Life Science, University of Liverpool, Liverpool, UK Medical Research Institute, University of Dundee, Dundee, UK Aberdeen Pain Research Collaboration (Musculoskeletal Research), Division of Applied Medicine, University of Aberdeen, Aberdeen, UK University of Dundee, Health Informatics Centre, Dundee, UK BHF Glasgow Cardiovascular Research Centre, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK Molecular Medicine Centre, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, UK Molecular and Clinical Pharmacology, Faculty of Health and Life Science, University of Liverpool, Liverpool, UK.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Goodson
authors.forename: Blair H
authors.initials: BH
authors.lastname: Smith
authors.forename: Lynne J
authors.initials: LJ
authors.lastname: Hocking
authors.forename: Mark M
authors.initials: MM
authors.lastname: McGilchrist
authors.forename: Anna F
authors.initials: AF
authors.lastname: Dominiczak
authors.forename: Andrew
authors.initials: A
authors.lastname: Morris
authors.forename: David J
authors.initials: DJ
authors.lastname: Porteous
authors.forename: Andreas
authors.initials: A
authors.lastname: Goebel
mesh_terms: D000328:Adult; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D018672:Community Health Planning; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose
keywords: Cardiovascular risk; Chronic pain; Metabolic syndrome; Pain intensity