Blood pressure monitoring device against a blue background

Can pain and inflammation cause high blood pressure?

Written on November 23, 2022 by Dr. Ron Gasbarro, PharmD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Blood pressure (BP) is the force of blood pushing against the walls of the arteries. The heart is the muscle that pumps oxygenated blood into the network of arteries to nourish every cell. One’s blood pressure goes up and down throughout any given day. Typically, BP is lowest when we sleep or are relaxing. However, it may spike when we face a stressful event. A dog may leap in front of your car, and you hit the brakes. Your credit card statement arrives, and you are shocked at the amount you owe. BP goes up and down all day. This is normal.

We measure BP because it is an accurate indicator of how well our cardiovascular system is working. A BP reading is expressed as two numbers, such as 120/80 mmHg (millimeters of mercury). The first, or top, number assesses the systolic pressure, that is, the pressure on the arteries as the heart contracts and pumps blood. The second, or bottom, number measures the diastolic pressure – the pressure on the arteries when the heart rests between beats.

The difference between high blood pressure and hypertension

High blood pressure refers to a nonspecific, usually temporary, elevation of blood pressure above 130/80 mmHg. Conversely, hypertension is a medical diagnosis in which blood pressure is continually elevated at or above 140/90 mmHg. When BP is persistently above 140/90, specific organ damage can occur, particularly to the kidneys, eyes, brain, and heart [1]. Thus, the latest guidelines recommend that BP should be lowered to avoid organ damage. Studies have demonstrated that this can be successfully accomplished with a combination of medications [2] and lifestyle changes, such as a low-sodium diet and exercise [3].

What causes hypertension?

Typically, hypertension develops over time. Unhealthy lifestyle choices, such as not getting enough regular physical activity or smoking can increase the risk of hypertension [2, 4]. Certain health conditions, such as diabetes and obesity, can also increase the risk of developing hypertension [2, 4]. Hypertension can also occur during pregnancy [5].

Does pain cause hypertension?

In general, two types of pain exist — acute pain and chronic pain.

Acute pain

Acute pain helps us survive within our environment. For example, you might place a hand on a hot stove. Your survival mechanisms immediately say, “Get your darn hand off that hot stove! Now!” And you pull your hand away. This response is a combination of nerves running up and down your spinal cord to your brain and back. Your cardiovascular system chimes in as well. Your sympathetic nervous system shifts into high gear and releases chemicals that cause your heart to beat faster and your arteries to tighten. The stress hormone cortisone is also released and throws your electrolytes out of whack to further destabilize your body. All these reactions cause your blood pressure to suddenly climb sharply [6]. The pain that lingers is to remind you what happened to prevent additional injury and to start the healing process. The brain also releases naturally occurring opioids to quell the pain. At the same time, your BP begins to return to normal.

Chronic pain

This type of pain lingers over time. While in acute pain, BP returns to normal as the body begins its healing process, in chronic pain, the opposite is true [6]. The constant onslaught of pain stimuli from, for example, arthritis, cancer, or muscle damage, keeps the cardiovascular system in auto drive, that is, it does not shut off. Studies have demonstrated that a link between chronic pain and hypertension exists [7]. The most plausible cause is that chronic pain uses up the natural opioid receptors in the brain. This has the effect of increasing your sensitivity to pain. This long-lasting pain causes hypertension. From a therapeutic standpoint, both the pain and the hypertension should be treated. Analgesics, whether narcotic or non-narcotic, plus a drug for hypertension can give the body a rest and stave off any organ damage caused by untreated hypertension secondary to chronic pain.

Does inflammation cause hypertension?

Like pain, there are two types of inflammation — acute and chronic.

Acute inflammation

Acute inflammation is the body’s normal tissue response to injuries, foreign bodies, and other external factors, such as dust. Here, the body’s tissues defend themselves by setting the healing process into motion. This type of flareup occurs when you are sick with a common virus or sustain an injury like a laceration or broken bone. Here, inflammatory cells are released to destroy bacteria or help heal a wound [8]. As in acute pain, the acute inflammatory phase is relatively short-lived, and any cardiovascular involvement is transient.

Chronic inflammation

In this type of inflammation, the body continues sending inflammatory cells even when there is no outside danger. For example, in rheumatoid arthritis inflammatory cells and substances attack joint tissues leading to an inflammation that ebbs and flows, causing severe damage to joints accompanied by pain and deformities [9].

Research has revealed that certain social, environmental, and lifestyle factors can promote chronic inflammation that can, in turn, lead to several diseases that jointly represent the leading causes of disability and mortality worldwide [10]. These conditions include cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease, and autoimmune and neurodegenerative disorders.

In terms of hypertension, recent evidence suggests that inflammation can lead to the development of hypertension and that oxidative stress – free radicals in the environment, such as air pollution – as well as endothelial dysfunction – a type of coronary artery disease – are involved in the inflammatory process [11]. Research shows that aging may also be involved in concomitant inflammation [12] and hypertension [13, 14]. Future studies should prove essential for focusing on whether anti-inflammatory drugs have benefits for reversing hypertension. If so, anti-inflammatory drugs could be used in treating hypertension in the future.

Take-away points

  • Both pain and inflammation are common occurrences that can temporarily raise blood pressure
  • When pain and inflammation evolve from acute to chronic, hypertension can become a medical condition that can result in end-organ damage
  • As the exact mechanisms behind chronic pain and inflammation become better elucidated, therapies may be directed toward controlling the chronic processes as well as directly targeting blood pressure.

To help get a better understanding of inflammation in your body, it may be useful to take the Everlywell Inflammation Test, which measures hs-CRP levels as well as vitamin D with easy sample collection from the convenience of home.

Does alcohol cause inflammation?

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Foods that reduce inflammation

References

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  2. James PA, Oparil S, Carter BL, et al. JAMA. URL 2014;311:507–20. Accessed November 2022
  3. Eckel RH, Jakicic JM, Ard JD, et al. URL. Circulation. 2014;129(25 Suppl 2):S76-99. Accessed November 2022
  4. Whelton P, Carey R, Aronow W, et al. URL. J Am Coll Cardiol. 2018, 71: e127–e248. Accessed November 2022
  5. Moser M, Brown CM, Rose CH, Garovic VD. URL J Hypertens. 2012;30:1092-1100. Accessed November 2022
  6. Saccò M, Meschi M, Regolisti G, et al. URL. J Clin Hypertens (Greenwich). 2013;15:600-5. Accessed November 2022
  7. Bruehl S, Chung OY, Jirjis JN, Biridepalli S. URL. Clin J Pain. 2005;21:147-53. Accessed November 2022
  8. Schultz GS, Chin GA, Moldawer L, et al. Principles of Wound Healing. In: Fitridge R, Thompson M, editors. Mechanisms of Vascular Disease: A Reference Book for Vascular Specialists [Internet]. Adelaide (AU): University of Adelaide Press; 2011. 23. Available from: URL Accessed November 2022
  9. Yap HY, Tee SZ, Wong MM, Chow SK, Peh SC, Teow SY. URL. Cells. 2018;7:161.
  10. Furman D, Campisi J, Verdin E, et al. URL. Nat Med. 2019;25:1822-32. Accessed November 2022
  11. Dinh QN, Drummond GR, Sobey CG, Chrissobolis S. URL. Biomed Res Int. 2014;2014:406960. Accessed November 2022
  12. Patrick DM, Van Beusecum JP, Kirabo A. URL. Curr Opin Physiol. 2021;19:92-8.
  13. Kopp C, Linz P, Dahlmann A, et al. URL. Hypertension. 2013;61:635-40. Accessed November 2022
  14. Liberale L, Badimon L, Montecucco F, Lüscher TF, Libby P, Camici GG. URL. J Am Coll Cardiol. 2022;79:837-47. Accessed November 2022
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