The Presence Of Pain, Its Characteristics And Relation To The Degree Of Blood Pressure Control In Patients With Arterial Hypertension

Background Headache is the most frequent and typical manifestation of arterial hypertension (HTN) but the prevalence of pain in other locations and its detailed characteristics in patients with HTN remain unknown. Furthermore, the influence of pain on the effectiveness of the antihypertensive treatment has never been comprehensively studied.The aim of the study was to analyze the prevalence and characteristics of pain and relation to blood pressure control and the effect of antihypertensive treatment on pain in patients with HTN.Material and methods 122 patients with the diagnosis of primary HTN (70 women and 57 men; age 55.7 +/- 15.6 years) filled the modified McGill Melzack Pain Questionnaire. Mean time from HTN diagnosis was 12.9 +/- 10.9 years. All patients were treated for hypertension receiving a mean number of 2.5 +/- 1.5 blood pressure-lowering medications. 27% of the patients fulfilled the criteria of resistant hypertension. Mean arterial blood pressure from the last three measurements was 141/84 mm Hg .Results As many as 87% of the patients with HTN reported pain in any location. The most common pain locations were lower limbs - shanks, knees, feet (60%) and the head (52%). The most prevalent pain characteristics were neuromuscular (36%), dull (25%) and paroxysmal (47%). Pain was associated with body movements in 64% of the patients. Mean pain intensity in a 10-point scale was 5.9 +/- 2.2. The intensity of pain did not correlate with the number of antihypertensive drugs. In a group of patients with well-controlled blood pressure (<140/90 mm Hg) the intensity of the pain tended to be lower than in patients with poorly controlled HTN (5.6 +/- 2.5 vs. 6.3 +/- 2.3; respectively; p = 0.02). Only 56% of the patients declaring pain were using pain-relief drugs. The number of pain localizations was higher in patients treated with renin-angiotensin-aldosterone system inhibitors (2.7 +/- 1.7 vs. 2.2 +/- 1.1) and in patients with diabetes (2.89 +/- 1.64 vs. 2.35 +/- 1.42; p = 0,09).Conclusions The prevalence of pain in patients with HTN is exceedingly high and seems to be related to the degree of blood pressure control.