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Low Pain Tolerance Is Associated With Coronary Angiography, Coronary Artery Disease, and Mortality: The Tromsø Study

Kristina Fladseth1,2, Haakon Lindekleiv2, Christopher Nielsen3,4,5

  • 1Cardiovascular Research Group Department of Clinical Medicine UiT The Arctic University of Norway Tromsø Norway.

Journal of the American Heart Association
|November 3, 2021
PubMed

Insights

Low pain tolerance is linked to a higher risk of needing coronary angiography and experiencing death. This study explored the connection between pain perception, coronary artery disease, and patient outcomes.

Area of Science:

  • Cardiology
  • Pain Research
  • Epidemiology

Background:

  • Coronary artery disease (CAD) presentation varies significantly among patients.
  • Pain tolerance is a potential factor influencing CAD presentation.
  • Understanding this link is crucial for risk stratification and patient management.

Purpose of the Study:

  • To investigate the association between pain tolerance, coronary angiography, CAD, and mortality.
  • To explore how pain perception influences the diagnosis and progression of coronary artery disease.

Main Methods:

  • Utilized data from 9576 participants in the Tromsø Study (2007-2008) with no prior CAD history.
  • Employed the cold-pressor pain test to assess pain tolerance.
  • Applied Cox-regression models with a median follow-up of 10.4 years to analyze outcomes, including coronary angiography, obstructive CAD, and death.

Main Results:

  • Low pain tolerance was associated with a 19% increased risk of coronary angiography and a 22% increased risk of obstructive CAD.
  • In women, low pain tolerance significantly increased the risk of obstructive CAD (54%) among those undergoing angiography.
  • Low pain tolerance independently predicted increased mortality risk (1.40 HR) after adjusting for CAD and cardiovascular risk factors.

Conclusions:

  • Low cold pressor pain tolerance is a significant predictor of increased risk for coronary angiography and all-cause mortality.
  • Pain tolerance may play a role in the manifestation and outcomes of coronary artery disease.
  • Further research can explore the underlying mechanisms connecting pain perception and cardiovascular health.

Keywords:
coronary angiographycoronary artery diseaseheart disease risk factorsmicrovascular anginapain measurement

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