疼痛、焦虑与日常活动对心脑血管疾病高风险人群自评健康状况的影响OA

Objective To explore the relative contributions and pathways of pain,anxiety,and usual activities in the EuroQol five dimensions questionnaire(EQ-5D)to self-rated health among individuals at high risk of cardiovascular and cerebrovascular diseases. Methods A cross-sectional design was used.A multistage stratified random sampling survey was conducted in Jing'an District,Shanghai,from January to March 2025.A total of 2410 community adults were enrolled,and individuals at high risk of cardiovascular and cerebrovascular diseases were identified.Data were collected including sociodemographic characteristics,behavioral factors,physical examination indicators,chronic disease status,as well as scores for pain,anxiety,and usual activities in the EQ-5D and the results of the EuroQol visual analogue scale(EQ-VAS).Multivariate linear regression analysis was used to examine the associations between EQ-5D dimension scores and EQ-VAS score.Relative weight analysis was applied to quantify the relative contribution of each EQ-5D dimension score to the coefficient of determination of the model.The Bootstrap method was used to verify whether anxiety could exert an indirect effect on self-rated health via pain and usual activities. Results A total of 212 high-risk individuals were included,of whom 189(89％)were male.Multivariate linear regression analysis showed that pain(β=-3.615,95％CI-6.138--1.093,P=0.005),anxiety(β=-5.743,95％CI-10.294--1.192,P=0.014),and usual activities(β=-2.902,95％CI-5.752--0.051,P=0.046)were significantly negatively associated with EQ-VAS score.Relative weight analysis indicated that the three EQ-5D dimensions collectively explained 16.17％of the coefficient of determination in the model.Pain made the largest relative contribution(6.40％,95％CI 1.92％-12.77％),followed by anxiety(6.01％,95％CI 1.35％-12.81％),and usual activities yielded the smallest relative contribution(3.76％,95％CI 1.04％-7.90％).Mediation analysis revealed that anxiety had indirect effects on self-rated health through pain(indirect effect=-3.15,95％CI-5.55--1.23)and usual activities(indirect effect=-2.32,95％CI-5.38--0.31). Conclusions Pain,anxiety,and usual activities are important influencing factors of self-rated health among individuals at high risk of cardiovascular and cerebrovascular diseases.Anxiety may reduce self-rated health by exacerbating pain and impairing usual activities.Comprehensive management of pain and anxiety should be emphasized in health interventions for these individuals.