Cerebrovascular Risk from Chronic Pain

Chronic Pain May Increase Cardiac and Cerebrovascular Event Risk – Clinical Pain Advisor – by Kwamesha Joseph – May 2020

Individuals with chronic pain may have an increased risk for major adverse cardiac and cerebrovascular events (MACCEs), according to study results published in Pain Medicine.

Outcomes included

  • all-cause mortality,
  • stroke,
  • a need for coronary angioplasty, and
  • occurrence of acute myocardial infarction.

Participants with chronic pain had a higher prevalence of underlying comorbidities such as hypertension, diabetes, renal diseases, and depression.   

After adjusting for these comorbidities and others, researchers found that participants with chronic pain had a higher risk for MACCE than those without chronic pain (adjusted hazard ratio [AHR], 1.3; 95% CI, 1.3 -1.4)

Researchers also found that 5.5% of the participants used opioids, and that nonsteroidal anti-inflammatory drugs were the most common analgesics used among participants with chronic pain (79.7%)

Individuals taking opioids had a higher risk for MACCEs than those who did not use opioids.

Duh: if they are taking opioids, it means their pain is more severe! In what other medical context is a medication discussed and regulated without any concern for the patient or reason it was prescribed?

Why is it that investigators and researchers never take into account that opioids are taken for severe pain? In what other medical context is a medication in itself regulated without any concern for the patient or reason it was prescribed?

The opioid “studies” all read as though taking opioids were some kind of totally unnecessary bad habit.

Investigators noted that the possible reasons for increased occurrence of MACCE in patients with chronic pain included

  • “reduced activity,
  • disability,
  • sleep disturbance,
  • fatigue, and
  • mood alterations such as anxiety and depression.”
Reference
Chung K-M, MD. Chung-Han H, PhD, Chen Y-C, MS, et al. Chronic pain increases the risk for major adverse cardiac and cerebrovascular events: a nationwide population-based study in Asia. Pain Medicine. doi:10.1093/pm/pnaa107

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