WEST HAVEN, CT — Pain and heart failure are highly comorbid, which can create problems for clinicians attempting to control the conditions.
A study from the VA Connecticut Healthcare System in West Haven, CT, and several major universities sought to quantify differences in pain intensity and pain medication prescriptions among veterans with comorbid heart failure and pain and those with pain alone.
The blinded for review cohort included 5.2 million veterans diagnosed with a musculoskeletal disorder between 2000 and 2013. Participants included 3,950 veterans with comorbid heart failure and back pain who were compared to 165,290 VHA patients with back pain alone. The study was published in Heart & Lung.1
Results indicated that those with heart failure and back pain had a higher likelihood of moderate/severe pain (OR = 1.12; 95% CI 1.04-1.21), a higher likelihood of opioids (OR = 1.63; CI = 1.52-1.75) and/or gabapentin prescriptions (OR = 1.18; CI = 1.02-1.36), but a lower likelihood of NSAID prescriptions (OR = 0.57; CI = 0.50-0.66).
“Comorbid cardiovascular and pain conditions present a challenge in clinical management that warrants further study,” the authors wrote.
The concerns are especially widespread in the VHA. Chronic heart failure (CHF) is prevalent among 5% of veteran patients, according to a 2019 study in JAMA Network Open.2
- Cavanagh CE, Rosman L, Chui PW, DeRycke E, Bathulapalli H, Gandhi P, Bastian LA, Burg MM, Brandt C, Goulet JL. Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain. Heart Lung. 2021 Jul 1;50(6):770-774. doi: 10.1016/j.hrtlng.2021.04.016. Epub ahead of print. PMID: 34225088.
- Groeneveld PW, Medvedeva EL, Walker L, Segal AG, Menno DM, Epstein AJ. Association Between Spending and Survival of Chronic Heart Failure Across Veterans Affairs Medical Centers. JAMA Netw Open. 2019;2(7):e197238. doi:10.1001/jamanetworkopen.2019.7238
