A study of more than 200,000 UK adults reports that chronic pain—especially when widespread—is associated with a greater risk of developing high blood pressure. The link appears to be partly mediated by depression and inflammation, underscoring the value of pain management and blood-pressure monitoring.
New research published on Nov. 17, 2025, in Hypertension finds that adults reporting chronic pain faced a higher likelihood of developing high blood pressure over long-term follow-up.
The analysis drew on 206,963 participants from the UK Biobank, which recruited more than 500,000 adults ages 40–69 across England, Scotland and Wales between 2006 and 2010. In this study sample, the average age was 54; 61.7% were women; and 96.7% were white. Participants identified pain locations and whether pain persisted for at least three months. Depression was assessed by questionnaire, and inflammation was measured using C‑reactive protein (CRP) blood tests.
After a median of 13.5 years, nearly 10% of participants developed hypertension, identified from hospital records using ICD‑10 diagnostic codes. Compared with those reporting no pain:
- Short‑term pain was linked to a 10% higher risk of hypertension.
- Chronic localized pain was linked to a 20% higher risk.
- Chronic widespread pain was linked to a 75% higher risk.
In site‑specific analyses, chronic widespread pain was associated with a 74% higher risk; chronic abdominal pain, 43%; chronic headaches, 22%; chronic neck/shoulder pain, 19%; chronic hip pain, 17%; and chronic back pain, 16%.
“The more widespread their pain, the higher their risk of developing high blood pressure,” said lead author Jill Pell, M.D., C.B.E., the Henry Mechan Professor of Public Health at the University of Glasgow. “This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.”
Mediation analyses indicated that depression explained 11.3% of the pain–hypertension association, while CRP‑based inflammation explained 0.4%, for a combined 11.7% mediated effect. Researchers adjusted for several factors, including smoking, alcohol intake, physical activity, sedentary time, sleep duration, and fruit and vegetable consumption.
The authors noted limitations: pain was self‑reported and measured once; incident hypertension relied on diagnostic coding; and the cohort was predominantly middle‑aged white British adults, which may limit generalizability to other populations.
Offering outside perspective, Daniel W. Jones, M.D., FAHA—chair of the 2025 AHA/ACC high blood pressure guideline writing committee—said, “It is well known that experiencing pain can raise blood pressure in the short term, however, we have known less about how chronic pain affects blood pressure. This study adds to that understanding, finding a correlation between the number of chronic pain sites and that the association may be mediated by inflammation and depression.” He urged randomized trials of pain‑management strategies and cautioned that commonly used NSAIDs such as ibuprofen can raise blood pressure. “Chronic pain needs to be managed within the context of the patients’ blood pressure,” he said.
The findings support closer blood‑pressure monitoring and careful pain management in patients with persistent pain, the researchers said.
