title: Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study.
abstract: 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.
authors.affiliation: Division of Emergencies and Critical Care, Department of Anesthesiology, Oslo University Hospital, Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway, r.b.olsen@medisin.uio.no.
authors.forename: Roy Bjørkholt
authors.initials: RB
authors.lastname: Olsen
authors.forename: Stephen
authors.initials: S
authors.lastname: Bruehl
authors.forename: Christopher Sivert
authors.initials: CS
authors.lastname: Nielsen
authors.forename: Leiv Arne
authors.initials: LA
authors.lastname: Rosseland
authors.forename: Anne Elise
authors.initials: AE
authors.lastname: Eggen
authors.forename: Audun
authors.initials: A
authors.lastname: Stubhaug
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D059350:Chronic Pain / Q000453:epidemiology* / Q000503:physiopathology*; D003080:Cold Temperature; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D013312:Stress, Physiological / Q000502:physiology*