Authors: Chen D, et al.
Anesthesia & Analgesia 141(3): 492-501, September 2025. doi:10.1213/ANE.0000000000007228
This UK Biobank prospective cohort study examined the influence of pain intensity on the development and progression of cardiometabolic multimorbidity (CMM). Among 429,145 participants followed for a median of 12.8 years, 13.1% developed an initial cardiometabolic disease (ICMD), 19.6% of those progressed to CMM, and 5.3% of the cohort died.
Chronic multilocation pain (CMLP) and chronic widespread pain (CWSP) significantly increased the risk of progression from ICMD to CMM, with CWSP showing the strongest association. In contrast, short-term pain (STP), chronic single-location pain (CSLP), and CMLP were associated with reduced mortality risk after ICMD, and STP also lowered overall mortality risk from enrollment. Disease-specific analysis revealed that CMLP and CWSP particularly increased the risk of progression from type 2 diabetes and ischemic heart disease to CMM, while CWSP alone substantially raised the risk of worsening from heart failure to CMM.
What You Should Know:
Chronic widespread and multilocation pain independently accelerate progression of cardiometabolic multimorbidity. Shorter-duration or localized pain may not carry the same risk and can even be associated with lower mortality. Effective strategies to reduce chronic pain could play a preventive role in cardiometabolic health.
Clinical Relevance:
For anesthesiologists, perioperative physicians, and pain specialists, this study highlights that chronic pain is not just a quality-of-life concern but a measurable risk factor for worsening cardiometabolic disease. Addressing and managing chronic widespread pain could help slow CMM progression, reduce mortality, and should be considered when developing multidisciplinary care and follow-up plans.
References
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Thank you to Anesthesia & Analgesia for allowing us to use this article.