In this issue of the Scandinavian Journal of Pain, Fayaz et al.  report on the relationship between chronic pain and cardiovascular disease, a conundrum occupying researchers for decades: causal relationship or independent co-variance?The cardiovascular outcomes analyzed were cardiovascular mortality, cardiac disease, and cerebrovascular disease. The authors searched major databases and out of 11,100 retrieved studies, 25 studies matched the inclusion criteria and were included for indepth analysis. A meta-analysis (of unadjusted study outcomes; 3–8 studies) demonstrated statistically significant associations between chronic pain, and, cardiovascular diseases, cardiac diseases, and cerebrovascular disease. The systematic review, also, found evidence supporting a dose–response relationship between severity of chronic pain and cardiovascular morbidity.The authors are to be congratulated on their laborious efforts dedicated to an important and very difficult research topic. If a causal effect is demonstrated, an improved management of chronic pain would logically lead to a decrease in cardiovascular morbidity, thus reducing the physical restrictions and burden placed on this severely, disabled patient group. But, as Fayaz et al. very diligently and prudently state, the included studies are “based on observational data with considerable variation in chronic pain taxonomy, methodology and study populations. The studies [take] an inconsistent and incomplete approach
Scandinavian Journal of Pain – de Gruyter
Published: Dec 29, 2017
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