Association between Hypertension and the Prevalence of Low Back Pain and Osteoarthritis in Koreans: A Cross-Sectional Study

<div><p>Background</p><p>Hypertension and musculoskeletal disorders are highly prevalent in adult populations. The objective of this study was to investigate the association between hypertension and prevalence of low back pain (LBP) and osteoarthritis in Koreans.</p><p>Methods</p><p>A total 17,128 participants (age ≥20 years) who answered low back pain and osteoarthritis items in the 4th Korean National Health and Nutrition Examination Survey (2007–2009) were analyzed. Odds ratios were calculated using logistic regression and were adjusted for age, sex, income level, education, occupation, BMI, smoking status, alcohol consumption, and physical activity.</p><p>Results</p><p>Lifetime prevalence of LBP in hypertensive subjects was 34.4%, and that of osteoarthritis 26.2%. LBP prevalence was significantly lower in hypertensives (fully adjusted OR 0.79; 95% CI 0.70–0.90), and both LBP and osteoarthritis prevalence was significantly lower in participants with systolic blood pressure ≥140mmHg than those with <120mmHg (fully adjusted OR 0.81; 95% CI 0.70–0.94, and 0.81; 95% CI 0.68–0.96, respectively). Prevalence of LBP in subjects with diastolic blood pressure ≥90mmHg was also significantly lower than those with <80mmHg (fully adjusted OR 0.73; 95% CI 0.63–0.85). LBP and osteoarthritis prevalence did not differ by systolic or diastolic blood pressure interval in respondents taking antihypertensive medication. LBP and osteoarthritis prevalence increased with longer hypertension duration (fully adjusted p for trend 0.028, and 0.0008, respectively).</p><p>Conclusions</p><p>Hypertension showed an inverse relationship with LBP and osteoarthritis prevalence, which may be ascribed to hypertension-associated hypalgesia, and antihypertensive medication intake and longer hypertension duration attenuated this association.</p></div

Associations Between Blood Pressure Levels and Low Back Pain or Osteoarthritis in Korean Surveyees of KNHANES IV aged ≥20 years^a.

<p>CI, confidence interval; KNHANES, Korean National Health and Nutrition Examination Survey; OR, odds ratio.</p><p>^a Hypertension diagnosis was made when patients met international standards (SBP≥140 mmHg or DBP≥90 mmHg) or were already on medication.</p><p>^b Adjusted for age, sex, household income, education, occupation, BMI, smoking, alcohol consumption and exercise patterns.</p><p>^c Adjusted for age, sex, education, occupation, BMI, alcohol consumption and exercise patterns in low back pain, and age, sex, education, BMI and exercise patterns in osteoarthritis. Backward elimination method was used with <i>P</i><0.05 regarded to be significant.</p><p>^d Lifetime low back pain: any previous experience of low back pain.</p><p>^e Lifetime osteoarthritis: any previous experience of osteoarthritis.</p><p>Associations Between Blood Pressure Levels and Low Back Pain or Osteoarthritis in Korean Surveyees of KNHANES IV aged ≥20 years<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138790#t002fn002" target="_blank">^a</a>.</p

Associations Between Hypertension Duration Period and Low Back Pain or Osteoarthritis in Korean Surveyees of KNHANES IV aged ≥20 years^a.

<p>CI, confidence interval; KNHANES, Korean National Health and Nutrition Examination Survey; OR, odds ratio.</p><p>^a Individuals with data for time of HTN diagnosis (N = 3167)</p><p>^b Adjusted for age, sex, household income, education, occupation, BMI, smoking, alcohol consumption and exercise patterns.</p><p>^c Adjusted for age, sex, education, occupation and BMI in low back pain, and age, sex, education and BMI in osteoarthritis. Backward elimination method was used with <i>P</i><0.05 regarded to be significant.</p><p>^d Lifetime low back pain: any previous experience of low back pain.</p><p>^e Duration period was classified as quartiles.</p><p>^f Lifetime osteoarthritis: any previous experience of osteoarthritis.</p><p>Associations Between Hypertension Duration Period and Low Back Pain or Osteoarthritis in Korean Surveyees of KNHANES IV aged ≥20 years<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138790#t005fn002" target="_blank">^a</a>.</p

Characteristics of Korean Surveyees of KNHANES IV aged ≥20 years (N = 17,128).

<p>DBP, diastolic blood pressure; KNHANES, Korean National Health and Nutrition Examination Survey; SBP, systolic diastolic blood pressure; SD, standard deviation.</p><p>^a Covariates included for adjustment.</p><p>^b<i>P</i>-value of t-test or Rao-scott chi-square test for continuous and categorical variables.</p><p>Characteristics of Korean Surveyees of KNHANES IV aged ≥20 years (N = 17,128).</p

Association between chronic TMD and quality of life as assessed by EQ-5D in participants aged ≥19 years of KNHANES Ⅳ, 2007 to 2009.

<p>Association between chronic TMD and quality of life as assessed by EQ-5D in participants aged ≥19 years of KNHANES Ⅳ, 2007 to 2009.</p

Influence of covariates in linear regression analyses of the association between TMD and quality of life in participants aged ≥19 years of KNHANES Ⅳ, 2007 to 2009.

<p>Influence of covariates in linear regression analyses of the association between TMD and quality of life in participants aged ≥19 years of KNHANES Ⅳ, 2007 to 2009.</p

Knee osteoarthritis prevalence in individuals with no cardiovascular related conventional medicine intake^a^,^b.

<p>Knee osteoarthritis prevalence in individuals with no cardiovascular related conventional medicine intake<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165325#t003fn001" target="_blank">^a</a>^,<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165325#t003fn002" target="_blank">^b</a>.</p

Characteristics of Koreans aged 50 years or over participating in the 5th KNHANES.

<p>Characteristics of Koreans aged 50 years or over participating in the 5th KNHANES.</p

Association between cardiovascular risk factors and knee osteoarthritis prevalence^a.

<p>Association between cardiovascular risk factors and knee osteoarthritis prevalence<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165325#t002fn001" target="_blank">^a</a>.</p

Association between the Framingham risk score and knee osteoarthritis prevalence^a.

<p>Association between the Framingham risk score and knee osteoarthritis prevalence<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165325#t004fn001" target="_blank">^a</a>.</p