You wake up with that back pain that's been bothering you for months. As the day progresses, your neck pain begins to flare up, then your hip pain. You're used to it now: it's your chronic pain, the one you manage with painkillers and physical therapy. What you probably don't realize, however, is that every single sore spot in your body is silently contributing to an increase in your blood pressure.
A study from the University of Glasgow looked at over 206.000 adults for 13 years, finding that Those living with widespread pain are 75% more likely to develop hypertensionThe mechanism? A vicious cycle where pain, depression, and inflammation feed off each other, pushing blood pressure ever higher.
When pain becomes a cardiovascular risk factor
The researcher Jill Pell of the University of Glasgow coordinated a massive analysis of 206.963 British adults in the UK Biobank, followed for an average of 13 and a half years. The results, published on November 17, 2025, in the journal Hypertension from the American Heart Association, show correlations that no previous study had quantified with this precision.
Chronic localized pain (a single area of the body that persists for more than three months) increases the risk of hypertension by 20%. Chronic widespread pain (multiple areas of the body) increases the risk to 75%.
But it's the discovery of the "how" that changes the game. 11,7% of this additional risk passes through two specific mediators: depression and inflammation. It's as if the pain triggered a biochemical cascade that, passing through the brain, ended up damaging the heart.
Over the 13 years of follow-up, nearly 10% of participants developed hypertension. Those suffering from chronic widespread pain showed a 75% increased risk, compared to 10% for temporary acute pain and 20% for localized chronic pain.
Depression was present in 11,3% of cases, inflammation (measured by C-reactive protein) in 0,4%.
The Geography of Chronic Pain: Not All Points Are Equal
The study also mapped which areas of the body, if chronically painful, most affect blood pressure. chronic abdominal pain increases the risk by 43%. chronic headaches of 22%. Neck, shoulders and cervical spine of 19%. The hip the 17% the back 16%. It's no coincidence: some areas are richer in nerve endings linked to the autonomic nervous system, which also regulates blood pressure.
As Pell explains:
The more widespread the pain, the higher the risk of developing hypertension. Part of the explanation is that having chronic pain makes depressive episodes more likely, and having depression makes high blood pressure more likely. This suggests that early recognition and treatment of depression in people with pain could help reduce the risk of hypertension.
The Infernal Triangle: Chronic Pain, Depression, Inflammation
The biological mechanism is more complex than it seems. Chronic pain constantly activates the sympathetic nervous system, the "fight or flight" response. This leads to a continuous release of stress hormones like cortisol and adrenaline, which in the short term increase the pressure to cope with an emergency. The problem is that here the emergency never ends.
The chronic stress response generates depression (the body "surrenders" in the face of a threat it cannot eliminate) and systemic inflammation (the immune system remains on high alert). Inflammation, measured in the study by C-reactive protein, damages blood vessel walls, making them stiffer. Stiff vessels offer more resistance to blood flow. And resistance means pressure. It's physics, even before it's medicine.
Managing pain to protect your heart
Daniel W. Jones, chair of the 2025 hypertension guidelines for the American Heart Association and the American College of Cardiology, who was not involved in the study, comments:
It's well known that acute pain can raise blood pressure in the short term. We knew less about how chronic pain affects blood pressure. This study adds to this understanding by finding a correlation between the number of chronic pain sites and whether the association may be mediated by inflammation and depression.
Jones suggests controlled clinical trials to explore how different approaches to pain management affect blood pressure. As we reported in 2021, there are already experimental methods such as the ultrasound renal denervation To lower blood pressure when medications aren't enough. But the new study suggests an even more fundamental approach: treating pain means preventing hypertension.
Be careful with anti-inflammatories. Jones emphasizes the importance of understanding how NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen can also raise blood pressure.
Yes: poorly treating chronic pain can worsen the cardiovascular risk it should instead mitigate.
A silent killer hiding another
High blood pressure is called the "silent killer" because it doesn't show symptoms until the damage is advanced. Chronic pain, on the other hand, is anything but silent. Yet, beneath its daily noise, it hides a danger few people realize: it's slowly damaging your cardiovascular system. The Glasgow study primarily involved middle-aged white British adults, so the findings may not apply universally to other populations. But the sample size (over 206.000 people) and the length of follow-up make the data quite robust.
If pain isn't just an orthopedic or neurological problem, but also a cardiac one, perhaps it's time to rethink how we treat it. Before the pressure reminds us that we should have done so.
