Qin, Pei;
Nicholl, Barbara I;
Ho, Frederick K;
Hanlon, Peter;
Celis-Morales, Carlos A;
Pell, Jill P;
(2025)
Association between pain and incident arrhythmias in 422,654 individuals: evidence from the UK Biobank cohort.
European Journal of Preventive Cardiology
10.1093/eurjpc/zwaf153.
(In press).
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Abstract
AIMS: Pain is associated with cardiovascular disease; however, its association with incident arrhythmias is unclear. We assessed associations between different pain characteristics (pain type, chronic pain, chronic widespread pain [chronic widespread pain], chronic musculoskeletal pain [chronic musculoskeletal pain], and number of chronic pain and chronic musculoskeletal pain sites) and incident cardiac arrhythmias, overall and by subtype. METHODS: The study included 422,654 UK Biobank participants. Pain was ascertained via a touchscreen questionnaire. The outcomes were incident arrhythmias: all cardiac arrhythmias, atrial fibrillation (AF), other (non-AF) cardiac arrhythmias, bradyarrhythmias, and ventricular arrhythmias. Multivariable Cox-proportional regression was used to investigate the associations. RESULTS: Over a mean (SD) follow-up of 13.19 (1.96) years, 36,860 (8.72%) participants developed arrhythmia. Compared with those without pain, those with chronic localized pain and chronic widespread pain had increased risk of all cardiac arrhythmias (hazard ratio [HR] 1.13, 95% confidence interval [CI], 1.10-1.17; 1.34, 1.19-1.51), AF (1.09, 1.05-1.14; 1.33, 1.15-1.55), and other cardiac arrhythmias (1.17, 1.12-1.22; 1.41, 1.20-1.66). There was evidence of a dose-relationship between number of chronic pain sites and risk of all cardiac arrhythmias, AF and bradyarrhythmias. Effect estimates were significantly larger among participants aged <60 years than those aged ≥60 years, and larger in women than men. CONCLUSIONS: Chronic pain was associated with cardiac arrhythmias. Whilst causation cannot be assumed in any observational study, there was evidence of both a temporal relationship and dose-relationship. These findings reinforce the need for pain management approaches that include a broad assessment of individuals' risk factors, wider health status, and appropriate vigilance for emerging conditions.
| Type: | Article |
|---|---|
| Title: | Association between pain and incident arrhythmias in 422,654 individuals: evidence from the UK Biobank cohort |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/eurjpc/zwaf153 |
| Publisher version: | https://doi.org/10.1093/eurjpc/zwaf153 |
| Language: | English |
| Additional information: | © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/). |
| Keywords: | chronic pain, chronic musculoskeletal pain, cardiac arrhythmias, atrial fibrillation, bradyarrhythmias, ventricular arrhythmias |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10206765 |
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