title: Cardiovascular activity and chronic pain severity.
abstract: OBJECTIVE
  Objective markers of chronic pain severity are needed when examining and treating patients with chronic pain whose suffering may be overstated or underestimated. This study tested a hypothesis that the strength of cardiovascular (CV) reactivity in response to a social evaluative threat and orthostatic challenge is a reliable index of severity of pain-related complaints.
  
  
  METHODS
  Measurement of CV reactivity and response styles in 34 men and 16 women with chronic pain from different bodily injuries, were retrieved from a larger database of patients. Measurement of CV reactivity in response to a postural challenge was repeated twice (sessions 1 and 2) on the same day of a medical examination which includes a psychosocial evaluation .
  
  
  RESULTS
  A decrease in systolic blood pressure (SBP) from session 1 to session 2 was found in subjects with low pain severity scores, but not in those with high pain severity scores. High scores for pain catastrophizing/ magnification and pain-related emotional distress were independently associated respectively with a SBP increase at an early-point in time and a SBP decrease at a mid-point in time after standing up from lying down. Stronger heart rate reactivity responses to orthostatic challenge indicated greater protection against the presence of these chronic pain symptoms.
  
  
  CONCLUSIONS
  This biobehavioral protocol enables measurement of chronic pain suffering and protection in three dimensions: physical, emotional, and cognitive.
authors.affiliation: Laboratory of Neuroimmunopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 8 Baltiyskaia ul., Moscow 125315, Russia. Electronic address: d.m.davydov@gmail.com.
authors.forename: Dmitry M
authors.initials: DM
authors.lastname: Davydov
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, #255, 2355 Westwood Blvd., Los Angeles, CA 90077, United States. Electronic address: sperlo@ucla.edu.
authors.forename: Solomon
authors.initials: S
authors.lastname: Perlo
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D058443:Catastrophization / Q000453:epidemiology / Q000503:physiopathology; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006339:Heart Rate; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult
keywords: Blood pressure; Chronic pain severity; Emotional distress; Orienting behavior; Orthostatic stress; Pain magnification