Journal of Behavioral Medicine

, Volume 37, Issue 6, pp 1193–1201 | Cite as

Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study

  • Roy Bjørkholt OlsenEmail author
  • Stephen Bruehl
  • Christopher Sivert Nielsen
  • Leiv Arne Rosseland
  • Anne Elise Eggen
  • Audun Stubhaug


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.


Chronic 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.

Supplementary material

10865_2014_9568_MOESM1_ESM.doc (78 kb)
Supplementary material 1 (DOC 78 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Roy Bjørkholt Olsen
    • 1
    Email author
  • Stephen Bruehl
    • 2
  • Christopher Sivert Nielsen
    • 3
  • Leiv Arne Rosseland
    • 1
    • 4
  • Anne Elise Eggen
    • 5
  • Audun Stubhaug
    • 4
    • 6
  1. 1.Division of Emergencies and Critical Care, Department of AnesthesiologyOslo University HospitalOsloNorway
  2. 2.Department of AnesthesiologyVanderbilt University School of MedicineNashvilleUSA
  3. 3.Division of Mental HealthNorwegian Institute of Public HealthOsloNorway
  4. 4.Faculty of MedicineUniversity of OsloOsloNorway
  5. 5.Department of Community Medicine, Faculty of Health SciencesUniversity of TromsøTromsøNorway
  6. 6.Division of Emergencies and Critical Care, Department of Pain Management and ResearchOslo University HospitalOsloNorway

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