Published: August 9, 2025
A Swedish study led by Dalarna University, in collaboration with Region Dalarna, Karolinska Institutet, and Uppsala University, found that long-term pain one year after a heart attack is linked to a sharply increased risk of premature death, comparable to smoking, high blood pressure, and diabetes. Researchers followed 98,400 SWEDEHEART patients for up to 16 years and observed that reported pain— even away from the chest — was associated with significantly higher mortality.
“We found that patients with severe pain had up to a 70 percent higher risk of dying during follow-up compared to those without pain,” said Lars Berglund, adjunct professor at Dalarna University and associate professor at Uppsala University.
The elevated risk was present even among younger, normal-weight patients without other risk factors. “This also applies to those who did not have chest pain, which suggests that long-term pain — regardless of where in the body — is a risk that is often overlooked in cardiac care,” said Johan Ärnlöv, professor at Dalarna University and Karolinska Institutet.
Since 2019 the WHO has classified chronic pain as a separate medical condition. The authors argue healthcare should treat persistent post-infarction pain as an independent risk factor that can also hinder rehabilitation by limiting exercise and lifestyle changes. “Pain patients may be a group that would benefit from more intensive preventive treatment to reduce mortality after a heart attack,” said Ann-Sofie Rönnegård, doctoral student at Dalarna University.
Based on SWEDEHEART data, the study recorded nearly 15,000 deaths; 43% of patients reported moderate or severe pain one year after infarction. Findings are published in IJC Heart & Vasculature.
Source: Dalarna University
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