Pain with depressive symptoms accompanies higher cardiovascular risk over nine years
A peer-reviewed observational analysis followed cardiovascular outcomes in 13,184 Chinese adults aged 45 and older. Those reporting both pain and depressive symptoms had a higher adjusted hazard than those reporting neither. The comparison used nine years of survey data and participant-reported physician diagnoses. It identifies an association while leaving the effects of treating pain or depressive symptoms untested.
Science··Morning
A nine-year survey follow-up
An analysis of a Chinese longitudinal survey followed 13,184 adults aged 45 and older using data from 2011–2020. At baseline, participants were grouped by reports of pain, depressive symptoms, both or neither. Later survey waves recorded cardiovascular outcomes reported by participants.[1]
Depressive symptoms were measured with a ten-item questionnaire; pain was assessed through questions about bodily pain and its locations. New cardiovascular outcomes were based on participants reporting physician diagnoses. The study did not assign a treatment for either pain or depressive symptoms.[1]
The combined group has the highest estimate
Across nine years, 2,834 participants reported cardiovascular events. Using participants with neither symptom as the reference, the adjusted hazard ratio for the combined group was 1.59; its uncertainty range extended from 1.44 to 1.76 at 95% confidence. The estimates for the separate groups were lower: 1.23 for depressive symptoms and 1.33 for pain.[1]
The models accounted for factors including age, sex, smoking, education and other health conditions. Alternative symptom cut-offs and pain-site analyses were also examined. These comparisons retain an observational design: statistical adjustment does not remove every possible difference between the groups.[1]
The association does not test treatment
Self-reported symptoms and diagnoses can introduce reporting error, while exclusions for missing data can change the analysed sample. Unmeasured factors may also affect the estimates. The results concern adults aged 45 and older in this Chinese survey, rather than every age group or population.[1]
The combined pain-and-depressive-symptom group had the largest adjusted estimate in the comparison. The follow-up does not show that treating either symptom reduces cardiovascular events, nor establish a causal pathway between them. That intervention question remains separate from the measured long-term association.[1]
