Uncontrollable high BP reduction may heighten risk for chronic pain in hypertensive patients

Hypertensive patients with uncontrollable reduction of high blood pressure (BP) are at increased risk for chronic pain incidence and severity, a study has shown. Practical recommendations in BP control are thus needed in consideration of the patients’ chronic pain.

The authors conducted a narrative review of respective studies with analysis of credibility of the findings. In some studies, aggressive reduction of high BP was associated with a return in pain symptoms, which may require more aggressive, long-term pain management.

Other studies suggested that long-term antihypertensive treatment could also elevate the risk for new cases of chronic pain.

“Pain initiates a central neuroplastic resetting of the baroreceptor activation accounting for sustained increase of BP with an adaptive ‘pain-killing’ or maladaptive ‘pain-complication’ effect associated with pain chronification,” the authors explained, adding that antihypertensive drugs could moderate such mechanisms.

However, certain antihypertensive medications and nondrug treatment might have different effects on pain mechanisms at various stages of treatments.

More research is thus warranted on the moderation effects of different antihypertensive manipulations on pain to improve the management of pain in patients with hypertension, according to the authors.

“Although progress has been made in the regulation of hypertension over the past decades, the US and some other countries have faced a significant rise in incidence of chronic pain management cases during the same period,” the authors noted.

“Studies of the relationship between pain and BP regulations propose that these two processes may be interconnected,” they added.