[Silent cardiopathy and aging. Assessment of pain threshold and tolerance]

The increase in pain threshold is one of the most significant hypothesis regarding the origin of silent ischaemic cardiopathy. The relations between silent ischaemia and aging aren't clear, although age is considered a risk factor in this pathology, in relation to a supposed peripheral neuropathy. In our study we evaluated the trend of pain threshold and of pain tolerance in subjects affected by silent ischaemic cardiopathy; we especially considered the role of aging. We studied 15 subjects with silent ischaemic cardiopathy and 15 with symptomatic cardiopathy; we evaluated the pain threshold and tolerance in three points using short and low frequency transcutaneous electrical impulses. All subjects were male; the exclusion criterion was a high level of anxiety and depression. Pain threshold values were measured with the same method in 40 healthy subjects, 5 per each decade and ranged from 10 to 90 years. Our data show a significant difference in pain threshold and tolerance between subjects affected by silent and non silent cardiopathy (33.9 +/- 12.9 mA vs 25.0 +/- 12.6 mA: p = 0.001 in the comparison of thresholds, and 66.8 +/- 20.9 mA vs 45.0 +/- 21.8: p = 0.000 in the comparison of tolerances). Regarding the higher significance of our data, compared with other studies, we considered the importance of our particular stimulation method and of the uniformity of the studied group. We didn't note any correlation between pain threshold and age. These data suggest that the differences evident between subjects with silent and symptomatic cardiopathy are linked to a different modulation of central pain perception uncorrelated with age.