Association between pain catastrophizing, spouse responses to pain, and blood pressure in chronic pain patients: a pathway to potential comorbidity.

BACKGROUND: Chronic pain has been shown to be highly comorbid with other medical conditions. Theoretical and empirical associations between pain and cardiovascular health can be made based on the current literature. Psychosocial variables associated with the pain experience may, however, have an impact on cardiovascular health.
PURPOSE: The purpose of this study was to examine how cognitive and interpersonal aspects of chronic pain, including pain catastrophizing (PC) and negative spouse responses (NSR), relate to systolic and diastolic blood pressure (SBP, DBP) as cardiovascular risk factors.
METHODS: Data were collected from 57 treatment-seeking patients with chronic musculoskeletal pain. Participants completed the West Haven-Yale Multidimensional Pain Inventory, Pain Catastrophizing Scale, and pain severity ratings based on an analog pain scale. In addition, participants consented to a medical chart review to collect blood pressure and prescribed medication data. Hierarchical linear regressions were used to test associations between PC and NSR, and blood pressure while controlling cardiac medication status.
RESULTS: A positive association between PC and both SBP and DBP was found. A positive association was also found for NSR and SBP. These findings suggest that psychosocial aspects of chronic pain may represent a direct risk for elevated blood pressure and, thus, increased risk for cardiovascular health problems.
CONCLUSIONS: Psychosocial aspects of pain may constitute a form of chronic stress as described in the cardiovascular reactivity literature. The findings highlight the need for comprehensive multidimensional treatments of pain.