Adults living with chronic pain may face a higher risk of developing hypertension, particularly when their pain is widespread, new research has suggested,
Published in the journal Hypertension, the journal of the American Heart Association, 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 hypertension than people who reported no pain, short-term pain or pain limited to specific areas.
The researchers said that their findings are partly linked to the fact that people suffering from chronic pain are more likely to have depression, which increases their risk of developing hypertension.
They therefore suggested that monitoring depression among patients with chronic pain could reduce their long-term risk of developing hypertension.
Chronic pain and increased hypertension risk
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 hypertension.
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 hypertension. During follow-up, which averaged 13.5 years, approximately 10% of participants developed hypertension.
The researchers found that patients with chronic widespread pain had a 75% higher risk of hypertension than people without pain. Those with chronic localised pain and short-term pain also faced increased, but lower risks of developing hypertension, 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 hypertension. 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 hypertension.
Need for early intervention
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.
‘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, healthcare 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.’
A version of this article was originally published by our sister publication Nursing in Practice.