Study: Pain After Heart Attack Linked With Long-Term Survival

Experiencing pain 1 year after a heart attack was associated with a higher likelihood of death within the next 8 years, according to a new study published in the Journal of the American Heart Association.

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Pain after a heart attack is common, including pain not associated with heart disease. According to the study, those who had moderate or extreme pain were more likely to die within the next 8 years compared to adults who did not have any post-heart attack pain.

“Pain causes significant loss of function and may lead to disability, all of which contribute to major, global public health issues,” said study author Linda Vixner, PT, PhD, an associate professor of medical science at the School of Health and Welfare at Dalarna University in Falun, Sweden, in a press release. “Research indicates that pain is linked to higher risk of cardiovascular disease and overall death; however, the impact of pain on death after a heart attack has not yet been examined in large studies.”

According to data from the American Heart Association, a heart attack happens approximately every 40 seconds in the United States. Data from 2005 to 2014 estimated that the annual incidence of heart attack in the United States was 605,000 new heart attacks and 200,000 recurrent heart attacks. The average age at the first heart attack is 65.5 years for men and 72 years for women.

The study analyzed health data from more than 18,300 adults who experienced a heart attack, using the Swedish quality registry SWEDEHEART. Adults in the study were younger than 75 years of age, were 24.5% women, and had heart attacks between 2004 and 2013.

Data on pain from a 2-month follow-up visit and a participant questionnaire completed 1 year after their heart attack was assessed to gauge whether they had no, moderate, or extreme pain. The pain they reported was more likely to be due to other health conditions.

According to the findings, nearly 45% of the participants reported moderate or extreme pain 1 year after their heart attack. Those with moderate pain were 35% more likely than those with no pain to die from any cause during the study period of 8.5 years. Furthermore, those who reported extreme pain were more than twice as likely to die during the 8.5-year study period, compared to heart attack survivors who had no pain.

Finally, 65% of the participants experiencing pain at the 2-month follow up were also experiencing pain at their 12-month follow up, suggesting persistent and long-term pain.

“After a heart attack, it’s important to assess and recognize pain as an important risk factor of future mortality,” Vixner said in the press release. “In addition, severe pain may be a potential obstacle to rehabilitation and participation in important heart-protective activities such as regular exercise; reduced or lack of physical activity, in turn, increases risk. For patients with pain, it is of particular importance to reduce other risk factors, such as smoking, high blood pressure, and high cholesterol levels.”

The study authors concluded that when recommending treatments and making prognoses for patients who have experienced a heart attack, health care professionals should consider whether they are experiencing moderate or extreme pain.

Reference

Experiencing pain after a heart attack may predict long-term survival. News release. American Heart Association. August 16, 2023. Accessed August 16, 2023. https://newsroom.heart.org/news/experiencing-pain-after-a-heart-attack-may-predict-long-term-survival?preview=2329