Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study
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We tested whether cardiovascular stress responsiveness is elevated in individuals experiencing chronic pain in a large general population sample. Blood pressure (BP) and heart rate (HR) were assessed at rest, during the cold pressor test, and during subsequent recovery in 554 individuals reporting daily chronic pain and 3,082 individuals free of chronic pain. After correcting for potential confounds, differences as a function of chronic pain status were noted for only 5 of 23 cardiovascular outcomes despite very high statistical power. Compared to the pain-free group, the chronic pain group displayed higher baseline HR/mean arterial pressure (MAP) ratio (p = .03), greater systolic BP (SBP) reactivity during the cold pressor test (p = .04), and higher HR/MAP ratio (p = .047) and significantly less SBP (p = .017) and MAP (p = .041) return to baseline during recovery. Findings suggest that changes in cardiovascular stress responsiveness associated with chronic pain are of limited clinical significance and unlikely to contribute to increased cardiovascular risk in the chronic pain population.
KeywordsChronic pain Blood pressure Cold pressor Stress reactivity Recovery Cardiovascular
This work was supported by The Norwegian Research Council (Grant # 177725 to AS) and South-Eastern Norway Regional Health Authority (Grant # 2413 to RBO). The authors would like to thank Mr. Rune Albrigtsen, Dr. Guro Grindheim, Dr. Karin Toska and Dr. Tor Hugo Hauge for technical support in processing the continuous blood pressure data. We are grateful for the valuable work of the technical staff of Tromsø 6. Above all, we thank the participants in the study.
Conflict of interest
Authors Roy Bjørkholt Olsen, Stephen Bruehl, Christopher Sivert Nielsen, Leiv Arne Rosseland, Anne Elise Eggen and Audun Stubhaug declare that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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