Shoulder pain and risk of developing hypertension and cardiovascular disease: A nationwide population-based cohort study in Taiwan

Abstract

Background: Shoulder pain is a common complaint across the population. It is associated with co-morbidities such as depression, diabetes mellitus, musculoskeletal disorders or cancer. However, there has been no study on the association of shoulder symptoms with future development of diseases. This nationwide population-based study aimed to investigate and clarify this association. Materials and Methods: A total of 76,304 patients with shoulder symptoms during 2000 and 2013 were selected from the National Health Insurance Research Database in Taiwan. Clinical endpoints such as hypertension (HTN) and cardiovascular disease (CVD) were evaluated by hazard ratio (HR) with 95% confidence interval (CI) after adjusting any confounding factors in Cox regression analysis. Results: Among the registered subjects, 16,570 (21.72%) and 8,453 (11.08%) patients developed HTN and CVD, respectively. After adjusting gender, age, household income, catastrophic illness, season, urbanization level and level of care, patients with shoulder symptoms aged ≥65 years had the highest risk of HTN (adjusted HR = 5.806, 95% CI = 5.464-6.169, P < 0.001), and CVD (adjusted HR = 4.371, 95% CI = 4.047-4.721, P < 0.001), with reference to younger age group of 22-44. The association of older age persisted in other cardiovascular problems (P < 0.001). Conclusions: Shoulder symptoms were associated with HTN and CVD. Future studies are required to elucidate the clinicopathogenesis.

Keywords

• Shoulder symptoms
• hypertension
• cardiovascular disease
• national health insurance research database
• Taiwan