Hypertension awareness and pain reports: data from the NHANES III

For this study we investigated the relationship between hypertension, pain reports, and hypertension awareness in a large and diverse sample of men and women.

Data collected during the Third National Health and Nutrition Examination Survey (NHANES III) were examined for reports of pain at four body sites (chest, back, legs, and gallbladder) in 9,427 adults. Respondents were classified into four groups based on their self-reports of a previous diagnosis of hypertension (yes, no) and their current blood pressure levels (hypertensive, normotensive).

Logistic regression analyses indicated that hypertensives who were unaware of their condition were significantly less likely to report chest pain than normotensives without a previous hypertension diagnosis; however, these groups did not differ in pain reports at other body sites. In contrast, both hypertensives and normotensives with a previous hypertension diagnosis were significantly more likely to report pain at several body sites as compared to normotensives without a previous hypertension diagnosis. It was also found that when hypertension awareness was held constant, resting systolic blood pressure was negatively associated with the likelihood of reporting chest and gallbladder pain.

These findings suggest that existing laboratory evidence of hypertension-related hypoalgesia may not translate to decreased daily pain symptoms, although there is intriguing evidence of dampened cardiac pain in hypertensives who are unaware of their condition.