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Does Hypertension Protect Against Chronic Musculoskeletal Complaints?
The Nord-Trøndelag Health Study
Knut Hagen, MD, PhD;
John-Anker Zwart, MD, PhD;
Jostein Holmen, MD, PhD;
Sven Svebak, PhD;
Gunnar Bovim, MD, PhD;
Lars Jacob Stovner, MD, PhD
Arch Intern Med. 2005;165:916-922.
Background Although an inverse relationship between pain sensitivity and hypertension has been described, it is still unknown whether hypertension may protect against chronic musculoskeletal complaints (MSCs). The aim of this study was to evaluate the relationship between blood pressure (BP) and prevalence of chronic MSCs at various anatomical sites.
Methods Two consecutive public health studies within the county of Nord-Trøndelag, Norway, were conducted between January 5, 1984, and February 15, 1986 (Nord-Trøndelag Health Study [HUNT] 1), and from August 1995 to June 1997 (HUNT-2). Among 46 901 adults who participated in both surveys, 24 127 (51.4%) in HUNT-2 who reported MSCs continuously for at least 3 months during the past year were defined as having chronic MSCs. The prevalence of chronic MSCs was estimated using multiple logistic regression, with odds ratio and 95% confidence interval as measures of association with systolic and diastolic BP.
Results A high systolic and diastolic BP was associated with a 10% to 60% lower prevalence of chronic MSCs, and there was a strong linear trend (P<.001) of decreasing prevalence of chronic MSCs with increasing BP values. The findings were remarkably consistent at all anatomical sites, for both sexes, across all age groups, and for systolic and diastolic BP measured in HUNT-1 and HUNT-2.
Conclusions Individuals with a high BP had a lower prevalence of chronic MSCs than individuals with a normal BP. One possible explanation may be the phenomenon of hypertension-associated hypalgesia, due to an interaction between the cardiovascular and pain regulatory systems. The effect of antihypertensive medication on this interaction should be evaluated in further studies.
Author Affiliations: Section of Neurology, Department of Clinical Neuroscience (Drs Hagen, Zwart, Bovim, and Stovner), and Department of Public Health and General Practice (Drs Holmen and Svebak), Faculty of Medicine, Norwegian University of Science and Technology; Norwegian National Headache Centre (Drs Hagen, Zwart, and Stovner); and National Centre for Spinal Disorders, St Olavs Hospital (Dr Zwart), Trondheim, Norway.
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