ReviewCureus2026
Autonomic Dysfunction as a Potential Pathophysiological Link Between Chronic Low Back Pain and Coronary Artery Disease: A Systematic Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic low back pain (CLBP) is a leading cause of disability worldwide and is increasingly recognized as a condition associated with systemic physiological alterations beyond musculoskeletal dysfunction. Emerging evidence suggests that autonomic nervous system dysregulation may be associated with impaired cardiovascular regulation and increased cardiovascular risk in individuals with CLBP. This systematic review aimed to evaluate the current evidence regarding autonomic dysfunction in CLBP and its potential association with cardiovascular disease. A comprehensive literature search was conducted according to the PRISMA 2020 guidelines across PubMed/MEDLINE, Scopus, Web of Science, EMBASE, CENTRAL, CINAHL, EBSCOhost, and Google Scholar from database inception through January 2026, along with gray literature sources. Studies evaluating autonomic or cardiovascular autonomic function in adults with CLBP were included. A total of 10 studies met the inclusion criteria. Most studies demonstrated reduced heart rate variability, diminished vagal activity, sympathetic predominance, impaired autonomic regulation, and delayed cardiovascular recovery in individuals with CLBP compared with healthy controls. Several studies also reported associations between autonomic dysfunction and pain-related disability, catastrophizing, kinesiophobia, and altered pain modulation. Population-based evidence suggested increased prevalence of coronary heart disease and myocardial infarction among individuals with CLBP, while interventional studies demonstrated improvements in autonomic regulation following yoga-based rehabilitation and spinal manipulative therapy. Overall, the certainty of evidence ranged from low to moderate because of methodological heterogeneity and the predominance of observational study designs. Current evidence suggests that CLBP is associated with clinically relevant autonomic and cardiovascular alterations. These findings highlight the importance of incorporating autonomic and cardiovascular assessment into multidisciplinary management strategies while emphasizing the need for further prospective and mechanistic research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.