title: Hypoalgesia related to elevated resting blood pressure is absent in adolescents and young adults with a history of functional abdominal pain.
abstract: Elevated resting blood pressure (BP) is hypoalgesic in healthy individuals, but this effect is absent in adults with chronic somatic pain. This study tested whether BP-related hypoalgesia is similarly altered in individuals with a history of chronic visceral pain in childhood. Resting BP was assessed in 94 adolescents and young adults with a known history of childhood functional abdominal pain (FAP) and 55 comparable healthy controls. Responses to an acute heat pain stimulus were then evaluated following exposure to two laboratory stressors. A significant participant type x systolic BP (SBP) interaction (p<.005) revealed that elevated resting SBP was associated with significantly higher heat pain threshold (p<.001) in healthy controls, but was unrelated to pain threshold in the FAP group. A similar pattern was observed for heat pain tolerance, with elevated SBP linked to significantly higher pain tolerance (p<.05) in healthy controls, but unrelated to tolerance in the FAP group. Dysfunction in BP-related hypoalgesia associated with FAP was evident regardless of whether childhood FAP had resolved or still persisted at the time of laboratory testing. Subgroup analyses indicated that BP-related hypoalgesia (in healthy controls) and FAP-linked absence of this hypoalgesia was observed only among females. Result suggest that childhood visceral chronic pain may be associated with relatively long-lasting dysfunction in overlapping systems modulating pain and BP that persists even after FAP resolves. Potential implications for later hypertension risk are discussed.
authors.affiliation: Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA Department of Pediatrics, Vanderbilt University School of Medicine, The Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bruehl
authors.forename: Christine M
authors.initials: CM
authors.lastname: Dengler-Crish
authors.forename: Craig A
authors.initials: CA
authors.lastname: Smith
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Walker
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D020886:Somatosensory Disorders / Q000175:diagnosis / Q000453:epidemiology*; D013714:Tennessee / Q000453:epidemiology; D055815:Young Adult