Cardiovascular risk factors and low back pain in a long-term follow-up of industrial employees

OBJECTIVES: Atherosclerosis of the lumbar vessels has been suggested as a mechanism leading to low-back pain (LBP). We studied whether seven cardiovascular disease (CVD) risk factors predict LBP. METHODS: A sample (N=902) stratified by gender, age, and occupational class was drawn from employees in an engineering company in 1973 and examined for body mass index (BMI), smoking, exercise, serum total cholesterol and triglyceride concentrations, systolic blood pressure (SBP), diastolic blood pressure (DBP), and LBP. By November 2000, 232 persons had died, 108 from cardiovascular causes. In 2000, 546 (81% of the survivors) responded to a follow-up questionnaire on, for example, LBP. RESULTS: Among the men, frequent local LBP at follow-up was predicted by high triglyceride and DBP levels and being a past smoker at baseline, adjusted for age, occupational class and frequent local LBP at baseline. In analogous models, high triglyceride and SBP levels and smoking (past and current) predicted frequent radiating LBP. An increased LBP score was predicted by a high BMI, serum total cholesterol, triglyceride, SBP and DBP levels, and smoking status at baseline. When BMI was allowed for, the associations between triglyceride level and all LBP outcomes persisted, as well as the association between SBP and frequent radiating LBP and an increased LBP score. An overall score of CVD risk factors showed a graded association with increased LBP. Among the women, a high BMI predicted frequent local and radiating LBP, and smoking at baseline predicted frequent radiating LBP and an increased LBP score. CONCLUSIONS: The study adds to the evidence supporting the atherosclerosis-LBP hypothesis particularly for men.