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Chronic pain in adults may increase their risk of high blood pressure, and the location and extent of pain and if they also had depression were contributing factors, according to new research published today.

The study was led by the University of Glasgow and is published in the American Heart Association Journal, Hypertension.

The researchers analyzed health data for more than 200,000 adults, and found that those who reported chronic pain throughout their bodies were more likely to develop high blood pressure than people who reported no pain, short-term pain or pain limited to specific areas.

Lead author of the study, Professor Jill Pell, the Henry Mechan Professor of Public Health at the University of Glasgow, said: “The more widespread their pain, the higher their risk of developing high blood pressure.

“Part of the explanation for this finding was that having chronic pain made people more likely to have depression, and then having depression made people more likely to develop high blood pressure. This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.”

High blood pressure and hypertension occurs when the force of blood pushing against the walls of blood vessels is too high, and it increases the risk of heart attack or stroke. According to previous research, chronic musculoskeletal pain — pain in the hip, knee, back or neck/shoulder that lasts for at least three months — is the most common type of pain in the general population. This study investigated the associations between the type, location and extent of pain throughout the body and the development of high blood pressure.

Inflammation and depression are both known to raise the risk of high blood pressure; however, no prior studies have examined the extent to which the link between pain and high blood pressure is mediated through inflammation and depression.

In this study, participants completed a baseline questionnaire and provided information about whether they had experienced pain in the last month that interfered with their usual activities. They noted if the pain was in their head, face, neck/shoulder, back, stomach/abdomen, hip, knee or all over their body. If they reported pain, they indicated whether pain had persisted for more than three months.

Depression was gauged based on participants’ responses to a questionnaire that asked about the frequency of depressed mood, disinterest, restlessness or lethargy in the previous two weeks. Inflammation was measured with blood tests for C-reactive protein (CRP).

After an average follow-up of 13.5 years, the analysis found that nearly 10% of all participants developed high blood pressure. Additionally, when compared to people who did not have pain, people with chronic widespread pain had the highest risk of high blood pressure (75% increased risk), while short-term pain was associated with a 10% higher risk and chronic localized pain was linked with a 20% higher risk.

When comparing sites of pain to people without pain, the analysis showed that chronic, widespread pain was associated with a 74% higher risk of developing high blood pressure; chronic abdominal pain with a 43% higher risk; chronic headaches with a 22% higher risk; chronic neck/shoulder pain with a 19% higher risk; chronic hip pain with a 17% higher risk; and chronic back pain with a 16% higher risk.

Depression (11.3% of participants) and inflammation (0.4% of participants) accounted for 11.7% of the association between chronic pain and high blood pressure.

Professor Pell added: “When providing care for people with pain, health care workers need to be aware that they are at higher risk of developing high blood pressure, either directly or via depression. Recognizing pain could help detect and treat these additional conditions early.”

Daniel W. Jones, M.D., FAHA, chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline and dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi, said: “It is well known that experiencing pain can raise blood pressure in the short term, however, we have known less about how chronic pain affects blood pressure. This study adds to that understanding, finding a correlation between the number of chronic pain sites and that the association may be mediated by inflammation and depression.”

The study reviewed data from the UK Biobank, and included data from 206,963 adults. Among all participants, 35.2% reported experiencing chronic musculoskeletal pain; 62.2% reported chronic pain at one site of the body; 34.9% reported chronic pain at two to three musculoskeletal sites; and 3.2% reported pain at four sites.

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk

First published: 17 November 2025