Chronic pain and incident hypertension: an observational study of 0.4 million adults

Chronic pain and hypertension have an enormous influence on both society and individuals. No previous research has examined the association between pain in multiple sites and the risk of hypertension.

A total of 402,230 individuals in the United Kingdom (UK) Biobank were included. The number of pain sites was categorized into 0 (no pain), 1, 2, 3, ≥ 4 sites of pain, and "pain all over the body". Cox proportional hazards model was respectively used to estimate the associations of the number of pain sites and specific pain with incident hypertension. Hazard ratio (HR) and 95% confidence interval (CI) was also calculated.

There were 105,617 (26.3%) hypertension cases occurred during a median follow-up of 13.35 years. The incidence of hypertension in 0, 1, 2, 3, ≥ 4 pain sites, and "pain all over the body" were 23.2%, 27.5%, 31.3%, 34.6%, 38.0%, and 42.0%, respectively. Participants with 3, ≥ 4 pain sites, and "pain all over the body" respectively had 36% (95% CI: 33%-40%), 50% (95% CI: 46%-55%), and 62% (95% CI: 55%-69%) higher risk of hypertension compared with those without pain. All types of pain including headache, facial pain, neck/shoulder pain, back pain, stomach/abdominal pain, hip pain, and knee pain, were positively associated with the incidence of hypertension.

We provided evidence that the number of pain sites was associated with an increased risk of hypertension. Certain specific types of pain, such as headache, neck/shoulder pain, and back pain, were also associated with hypertension risk.