Chronic widespread pain and cause of death: a 25-year follow-up study.

Introduction: Chronic widespread pain (CWP) has been suggested as a risk factor for mortality in cardiovascular diseases and malignancies. Different definition of CWP makes it difficult to compare previous studies.
Objectives: The aim was to study whether mortality and certain causes of death were increased among people with CWP and whether the definition of CWP influenced outcome.
Methods: This 25-year follow-up study included 2425 people from the general population, at baseline divided into 3 pain groups: CWP, chronic regional pain, and no chronic pain (NCP). Chronic widespread pain was defined according to the ACR1990 (CWP _ACR1990 ) and the more stringent WP2019 (CWP _WP2019 ) criteria. Causes of death were derived from official national register. Mortality, adjusted for age, sex, socioeconomic status, and smoking habits were analyzed with Cox regression.
Results: Overall mortality was not higher in people with CWP _ACR1990 (hazard ratio [HR] 1.08, P = 0.484) compared with NCP but significantly higher when using CWP _WP2019 (HR 1.32, P = 0.033). People with CWP _WP2019 had a higher mortality in diseases of the circulatory system (HR 1.32, P = 0.033) but not for neoplastic diseases. CWP _ACR1990 showed an increased mortality in malignancies of digestive organs. An increased mortality in influenza, pneumonia, acute kidney failure, and chronic kidney disease was observed for the CWP _WP2019 definition.
Conclusion: The more stringent WP2019 definition of CWP showed an excess risk for death, especially within diseases of the circulatory system. The results suggest that WP2019 defines a more vulnerable group in the population. Chronic widespread pain should be acknowledged in the clinic as a risk factor for increased mortality.
Competing Interests: The authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)