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Some studies have shown that persons with chronic widespread pain experience premature mortality, although data is equivocal. Attempts to investigate the mediators of such a relationship have focused on low levels of physical activity, and other lifestyle factors such as smoking and poor diet. Here, we used data from UK Biobank to determine whether such a relationship exists, estimate its magnitude and establish what factors mediate any relationship.
Approximately 0.5 million people ages 40-69yrs were followed from study recruitment (2006-2010) by linking to national death records up to mid-2015. Mortality among persons reporting pain all over the body for at least three months was compared with persons without chronic pain. 7130 participants reported chronic widespread pain at recruitment, and these individuals were more than twice as likely to die during followup, compared to persons with no chronic pain, in particular due to cancer, cardiovascular disease, respiratory disease, or from other disease-related causes. However, the excess risk was considerably reduced when adjusting for low levels of physical activity, high body mass index, poor quality diet and smoking.
Evidence is now clear that persons with chronic widespread pain experience excess mortality. Data from UK Biobank considerably reduces the uncertainty around the magnitude of excess risk and are consistent with the excess being explained by adverse lifestyle factors. These factors should be targeted in the management of such patients.