title: Self-reported pain severity is associated with a history of coronary heart disease.
abstract: BACKGROUND
  Previous studies have found an association between chronic pain and cardiovascular (CV) mortality.
  
  
  OBJECTIVE
  To explore the relationship between the severity of pain and non-fatal CV disease.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Of 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).
  
  
  CONCLUSIONS
  A 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.
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Parsons
authors.forename: J
authors.initials: J
authors.lastname: McBeth
authors.forename: G J
authors.initials: GJ
authors.lastname: Macfarlane
authors.forename: P C
authors.initials: PC
authors.lastname: Hannaford
authors.forename: D P M
authors.initials: DP
authors.lastname: Symmons
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index