Adults living with chronic pain may face a significantly higher risk of developing high blood pressure, particularly when pain is widespread and accompanied by depression, according to new research published today in Hypertension, a journal of the American Heart Association. The study found that both the location and extent of pain play an important role in shaping cardiovascular risk, and that mental health is a key factor linking persistent pain to hypertension.
Researchers analysed long-term health data from more than 200,000 adults in the United States. They discovered that people who reported chronic, widespread pain were far more likely to develop high blood pressure than those who experienced no pain, short-term discomfort or pain limited to one area of the body. “The more widespread a person’s pain, the greater their risk of developing high blood pressure,” said lead author Dr Jill Pell, Henry Mechan Professor of Public Health at the University of Glasgow. She explained that depression appeared to play an important role in this relationship, with chronic pain increasing the likelihood of depression, which in turn raised the risk of hypertension. The findings suggest that earlier detection and treatment of depression in people with chronic pain could help reduce their long-term risk of high blood pressure.
High blood pressure, also known as hypertension, occurs when the force of blood against artery walls remains consistently too high, placing strain on the heart and blood vessels and increasing the risk of heart attack and stroke. Blood pressure readings of 130/80 mm Hg or higher fall into the category of stage one or stage two hypertension. According to the latest 2025 joint guidelines from the American Heart Association and the American College of Cardiology, nearly half of all adults in the United States are affected by elevated blood pressure or hypertension, making it the leading cause of death both in the U.S. and worldwide.
Participants in the study completed detailed questionnaires at the outset, reporting whether they had experienced pain in the previous month that interfered with daily activities and whether that pain had lasted for more than three months. They recorded the specific location of pain, including the head, neck or shoulders, back, abdomen, hips and knees, or whether pain was felt throughout the body. Symptoms of depression were assessed through questions about mood, energy and interest levels over the previous two weeks, while inflammation was measured using blood tests that assessed C-reactive protein levels. Over an average follow-up of 13.5 years, nearly 10 per cent of participants developed high blood pressure.
Compared with people without pain, those with chronic widespread pain had the highest risk, with a 75 per cent increase in the likelihood of developing hypertension. Chronic abdominal pain raised risk by 43 per cent, headaches by 22 per cent, and persistent neck, shoulder, hip and back pain by between 16 and 19 per cent. Depression and inflammation together explained nearly 12 per cent of the link between chronic pain and high blood pressure. “When caring for people with chronic pain, clinicians need to be aware that these patients face elevated cardiovascular risk, either directly or through depression,” Dr Pell said. “Recognising and treating these issues early may help prevent future heart disease.”
More information: Pei Qin et al, Chronic Pain and Hypertension and Mediation Role of Inflammation and Depression, Hypertension. DOI: 10.1161/HYPERTENSIONAHA.125.25544
Journal information: Hypertension Provided by American Heart Association
