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ORIGINAL ARTICLE

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


1 Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Department of Internal Medicine, Division of Hematology-Oncology, Tri-Service General Hospital, Taipei, Taiwan
3 Department of Surgery, Division of Traumatic and General Surgery, Tri-Service General Hospital, Taipei, Taiwan
4 School of Pharmacy, Division of Colon and Rectal Surgery, Tri-Service General Hospital, Taipei, Taiwan
5 Department of Surgery, Division of Colon and Rectal Surgery, Tri-Service General Hospital, Taipei, Taiwan
6 Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
7 Department of Radiology, Taoyuan Armed Forced General Hospital, Taipei, Taiwan
8 Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Shih-Yu Lee,
National Defense Medical Center, Graduate Institute of Aerospace and Undersea Medicine, P. O. Box: 90048-514, Nei-hu 114, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_163_18

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.


 

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