Eight-year chronic pain trajectory and risk of cardiovascular disease: Evidence from 10 years of multicenter follow-up

Abstract

Previous studies have shown that chronic pain is associated with an increased risk of cardiovascular disease. However, there are no studies reporting the relationship between chronic pain trajectories and cardiovascular disease. The pooled data from two prospective cohorts, the Health Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), were included in this study, and five chronic pain trajectories were established based on eight years of follow-up. Cox proportional risk regression models were used to assess the association between different chronic pain trajectories and cardiovascular disease. A total of 19,234 participants were included in the study and were followed for 10 years. With the no pain trajectory as the reference group, increasing pain (HR:1.41, 95% CI: 1.24–1.61) and consistent pain (HR:1.27, 95% CI:1.14–1.43) trajectories were all significantly associated with an increased risk of cardiovascular disease. Conversely, the decreasing pain (HR:1.04, 95% CI:0.90–1.21) and fluctuating (HR:1.02, 95% CI:0.95–1.10) trajectory was not significantly associated with cardiovascular disease. However, no significant association was observed between chronic pain trajectories and stroke risk. The present study demonstrates that both increasing and consistent pain trajectories are significantly associated with an elevated risk of cardiovascular disease. In contrast, decreasing pain trajectories were not associated with cardiovascular risk. Therefore, incorporating chronic pain assessment into cardiovascular disease management is warranted.

Perspective

This longitudinal study highlights the importance of chronic pain trajectories in predicting cardiovascular disease. Findings support the integration of long-term pain patterns into cardiovascular risk assessments to improve prevention and management strategies.