Widespread chronic pain associated with risk of high blood pressure

Nurses and other health professionals must be aware of the risk of high blood pressure in patients with chronic pain, according to researchers.

Adults living with chronic pain may face a higher risk of developing high blood pressure, particularly when their pain is widespread, new research published in Hypertension, the journal of the American Heart Association, has suggested.

The findings show that the location and extent of pain can influence the likelihood of hypertension. People with chronic pain throughout their bodies were more likely to experience high blood pressure than people who reported no pain, short-term pain or pain limited to specific areas.

The researchers believe that the findings are partly linked to the fact that people suffering from chronic pain are more likely to have depression, which increases the likelihood of developing high blood pressure.

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They suggest that monitoring depression among patients with chronic pain could reduce their risk of developing their long-term risk of high blood pressure.

The most common type of pain in the general population is chronic musculoskeletal pain, which is pain in the hip, knee, back, or neck/shoulder that lasts for at least three months.

Previous studies show that patients who experience pain can experience an increase in blood pressure in the short term, but less is known about how chronic pain affects blood pressure.

This study investigated the associations between the type, location and extent of pain throughout the body and the development of high blood pressure.

Researchers at the University of Glasgow analysed health data from more than 200,000 adults using a baseline survey.

Participants provided information about whether they had experienced pain in the last month that interfered with their usual activities and whether this pain had persisted for more than three months. They noted whether the pain was in their head, face, neck/shoulders, back, stomach/abdomen, hip, knee, or all over their body.

Depression was measured via a questionnaire assessing mood, disinterest, restlessness, and lethargy over the previous two weeks, and inflammation was measured with blood tests for C-reactive protein (CRP).

Overall, patients with chronic pain experienced an increased risk of high blood pressure. During follow-up, which averaged 13.5 years, approximately 10% of participants developed high blood pressure.

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The researchers found that patients with chronic widespread pain had a 75% higher risk of high blood pressure than people without pain. Those with chronic localised pain and short-term pain also faced increased, but lower risks of developing high blood pressure, measured at 20% and 10% respectively.

The location of the pain was also important in relation to the associated risks. Those with widespread pain faced the highest risk, being 74% more likely to develop high blood pressure. Patients with abdominal pain faced a 43% higher risk, those with headaches a 22% higher risk, neck/shoulder a 19% higher risk, hip 17% higher risk and those with back pain faced the lowest risk at 16%.

The researchers found that 11.3% of the participants had depression and 0.4% inflammation, with these two conditions accounting for nearly 12% of the link between chronic pain and high blood pressure.

Lead author of the study, Professor Jill Pell, from the University of Glasgow, said: ‘The more widespread their pain, the higher their risk of developing high blood pressure.

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‘Part of the explanation for this finding was that having chronic pain made people more likely to have depression, and then having depression made people more likely to develop high blood pressure.

‘This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.’

Professor Pell added: ‘When providing care for people with pain, health care workers need to be aware that they are at higher risk of developing high blood pressure, either directly or via depression. Recognising pain could help detect and treat these additional conditions early.’