{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:40:05Z","timestamp":1787917205592,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,11,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The initial presentation to coronary angiography and extent of coronary artery disease (CAD) vary greatly among patients, from ischemia with no obstructive CAD to myocardial infarction with 3\u2010vessel disease. Pain tolerance has been suggested as a potential mechanism for the variation in presentation of CAD. We aimed to investigate the association between pain tolerance, coronary angiography, CAD, and death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We identified 9576 participants in the Troms\u00f8 Study (2007\u20132008) who completed the cold\u2010pressor pain test, and had no prior history of CAD. The median follow\u2010up time was 10.4\u00a0years. We applied Cox\u2010regression models with age as time\u2010scale to calculate hazard ratios (HR). More women than men aborted the cold pressor test (39% versus 23%). Participants with low pain tolerance had 19% increased risk of coronary angiography (HR, 1.19 [95% CI, 1.03\u20131.38]) and 22% increased risk of obstructive CAD (HR, 1.22 [95% CI, 1.01\u20131.47]) adjusted by age as time\u2010scale and sex. Among women who underwent coronary angiography, low pain tolerance was associated with 54% increased risk of obstructive CAD (HR, 1.54 [95% CI, 1.09\u20132.18]) compared with high pain tolerance. There was no association between pain tolerance and nonobstructive CAD or clinical presentation to coronary angiography (ie, stable angina, unstable angina, and myocardial infarction). Participants with low pain tolerance had increased risk of mortality after adjustment for CAD and cardiovascular risk factors (HR, 1.40 [95% CI, 1.19\u20131.64]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Low cold pressor pain tolerance is associated with a higher risk of coronary angiography and death.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021291","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T09:02:40Z","timestamp":1635930160000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Low Pain Tolerance Is Associated With Coronary Angiography, Coronary Artery Disease, and Mortality: The Troms\u00f8 Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-2640","authenticated-orcid":false,"given":"Kristina","family":"Fladseth","sequence":"first","affiliation":[{"name":"Cardiovascular Research Group Department of Clinical Medicine UiT The Arctic University of Norway Troms\u00f8 Norway"},{"name":"Department of Cardiology University Hospital of North Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haakon","family":"Lindekleiv","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of North Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Community Medicine UiT The Arctic University of Norway Troms\u00f8 Norway"},{"name":"Division of Ageing and Health Norwegian Institute of Public Health Oslo Norway"},{"name":"Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"\u00d8hrn","sequence":"additional","affiliation":[{"name":"Department of Psychology UiT The Arctic University of Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1207-9580","authenticated-orcid":false,"given":"Andreas","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of North Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Mannsverk","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of North Norway Troms\u00f8 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