LETTER TO THE EDITOR
Authors’ reply to comment by Grant et al doi:10.1002/ejp.518
We would like to thank Grant et al. for commenting on our study published in the European Journal of Pain investigating the relationship between chronic musculoskeletal pain (CMP) and cardiovascular disease (CVD) (Grant et al., 2014; Ryan et al., 2014). We appreciate their interest in our work and this important area of research. In their letter, Grant et al. suggest that we may have overlooked the potential role of vitamin D as a mediator of CMP and CVD (Grant et al., 2014). Our paper, which was a secondary analysis of a cross-sectional survey, Health Survey for England (2008) (National Centre for Social Research and University College London, 2011), identified an association between CMP and CVD. The correlation was stronger in older adults. In 2008, The Health Survey for England had a specific focus on physical activity, thus there was detailed information on the subjective physical activity and sedentary behaviour of the participants. There were also objectively measured physical activity and sedentary behaviour data for a subsample of individuals. This rich database allowed us to investigate the relationship between CMP and CVD and test whether physical activity or sedentary behaviour may be playing a role. This was not the case and neither physical activity nor sedentary behaviour appeared to explain the association. The Health Survey for England (2008) does not contain any data on vitamin D levels. Thus, vitamin D could not be included in our analytical model. In our discussion of the data we described potential mechanisms, which might explain the association between CMP and CVD. The discussion was not meant to be exhaustive, but rather to provide the reader with what we considered to be the most likely factors involved in the relationship. We did not include vitamin D as a potential explanatory mechanism because there is currently a lack of definitive data to support the role of vitamin D in chronic pain (Straube et al., 2010) or CVD (Bjelakovic et al., 2014). However, in light of the comments of Grant et al., there may be a need for additional research on the role of vitamin D and its association with CMP and CVD.
© 2014 European Pain Federation - EFIC®
Such work could inform the unmet need for new preventative treatment strategies that would help reduce the co-morbidity that accompanies these conditions. C.G. Ryan1, S. McDonough2, J.P. Kirwan3, S. Leveille4, D.J. Martin1 1 Health and Social Care Institute, Teesside University, Middlesbrough, UK 2 Institute of Nursing and Health Research, School of Health Sciences, University of Ulster, Jordanstown, UK 3 Lerner Research Institute, Department of Pathobiology, Cleveland Clinic, Ohio, USA 4 College of Nursing and Health Sciences, University of Massachusetts, Boston, USA
Conflicts of interest None declared.
References Bjelakovic, G., Gluud, L.L., Nikolova, D., Whitfield, K., Wetterslev, J., Simonetti, R.G., Bjelakovic, M., Gluud, C. (2014). Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev (1), CD007470. Grant, W.B., Mascitelli, L., Goldstein, M.R. (2014). Vitamin D deficiency may explain the association between chronic musculoskeletal pain and cardiovascular disease. Eur J Pain 18(6), 893–894. Ryan, C.G., McDonough, S., Kirwan, J.P., Leveille, S., Martin, D.J. (2014). An investigation of association between chronic musculoskeletal pain and cardiovascular disease in the Health Survey for England (2008). Eur J Pain 18, 740–750. Straube, S., Derry, S., Moore, R.A., McQuay, H.J. (2010). Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev (1), CD007771.
Web Reference National Centre for Social Research and University College London. (2011). Department of Epidemiology and Public Health, Health Survey for England, 2008 [computer file]. 3rd Edition (Colchester, Essex: UK Data Archive [distributor], August 2013. SN: 6397) Retrieved from: http://dx.doi.org/10.5255/UKDA-SN-6397-1
Eur J Pain 18 (2014) 895
895
Authors’ reply to comment by Grant et al doi:10.1002/ejp.518
We would like to thank Grant et al. for commenting on our study published in the European Journal of Pain investigating the relationship between chronic musculoskeletal pain (CMP) and cardiovascular disease (CVD) (Grant et al., 2014; Ryan et al., 2014). We appreciate their interest in our work and this important area of research. In their letter, Grant et al. suggest that we may have overlooked the potential role of vitamin D as a mediator of CMP and CVD (Grant et al., 2014). Our paper, which was a secondary analysis of a cross-sectional survey, Health Survey for England (2008) (National Centre for Social Research and University College London, 2011), identified an association between CMP and CVD. The correlation was stronger in older adults. In 2008, The Health Survey for England had a specific focus on physical activity, thus there was detailed information on the subjective physical activity and sedentary behaviour of the participants. There were also objectively measured physical activity and sedentary behaviour data for a subsample of individuals. This rich database allowed us to investigate the relationship between CMP and CVD and test whether physical activity or sedentary behaviour may be playing a role. This was not the case and neither physical activity nor sedentary behaviour appeared to explain the association. The Health Survey for England (2008) does not contain any data on vitamin D levels. Thus, vitamin D could not be included in our analytical model. In our discussion of the data we described potential mechanisms, which might explain the association between CMP and CVD. The discussion was not meant to be exhaustive, but rather to provide the reader with what we considered to be the most likely factors involved in the relationship. We did not include vitamin D as a potential explanatory mechanism because there is currently a lack of definitive data to support the role of vitamin D in chronic pain (Straube et al., 2010) or CVD (Bjelakovic et al., 2014). However, in light of the comments of Grant et al., there may be a need for additional research on the role of vitamin D and its association with CMP and CVD.
© 2014 European Pain Federation - EFIC®
Such work could inform the unmet need for new preventative treatment strategies that would help reduce the co-morbidity that accompanies these conditions. C.G. Ryan1, S. McDonough2, J.P. Kirwan3, S. Leveille4, D.J. Martin1 1 Health and Social Care Institute, Teesside University, Middlesbrough, UK 2 Institute of Nursing and Health Research, School of Health Sciences, University of Ulster, Jordanstown, UK 3 Lerner Research Institute, Department of Pathobiology, Cleveland Clinic, Ohio, USA 4 College of Nursing and Health Sciences, University of Massachusetts, Boston, USA
Conflicts of interest None declared.
References Bjelakovic, G., Gluud, L.L., Nikolova, D., Whitfield, K., Wetterslev, J., Simonetti, R.G., Bjelakovic, M., Gluud, C. (2014). Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev (1), CD007470. Grant, W.B., Mascitelli, L., Goldstein, M.R. (2014). Vitamin D deficiency may explain the association between chronic musculoskeletal pain and cardiovascular disease. Eur J Pain 18(6), 893–894. Ryan, C.G., McDonough, S., Kirwan, J.P., Leveille, S., Martin, D.J. (2014). An investigation of association between chronic musculoskeletal pain and cardiovascular disease in the Health Survey for England (2008). Eur J Pain 18, 740–750. Straube, S., Derry, S., Moore, R.A., McQuay, H.J. (2010). Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev (1), CD007771.
Web Reference National Centre for Social Research and University College London. (2011). Department of Epidemiology and Public Health, Health Survey for England, 2008 [computer file]. 3rd Edition (Colchester, Essex: UK Data Archive [distributor], August 2013. SN: 6397) Retrieved from: http://dx.doi.org/10.5255/UKDA-SN-6397-1
Eur J Pain 18 (2014) 895
895
