Chronic Pain and Its Association with Depressive Symptoms and Renal Function in Hypertensive Patients

Abstract

Chronic pain is a common concern and is considered to be one of the major problems in patients with chronic physical disorders. We studied the effect of pain in patients with hypertension with or without chronic kidney disease (CKD) and the association between pain and symptoms of depression. The study involved 158 hypertensive individuals (59.5% male, mean age 55 years), of whom 47 (29.8%) had CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m²). Pain was assessed with the pain/discomfort domain of the EuroQol-5 D, while depressive symptoms were assessed with the depression module of the Patient health questionnaire (PHQ-9). The prevalence of chronic pain in our sample was 44.3%. Women exhibited chronic pain more often compared to men (57.1% vs. 42.9%, p < 0.001). The presence of CKD was not significantly associated with a higher prevalence of chronic pain among hypertensive patients. Depressive symptoms were significantly associated with the presence of chronic pain. These findings were confirmed in the logistic regression analysis. Chronic pain is common in hypertensive individuals and the association with depression warrants further investigation and may have practical implications in managing these patients.

Keywords: chronic kidney disease; chronic pain; depression; hypertension.

Figure 1

Association between depression and chronic pain. (A) Hypertensive patients with or without impaired renal function reporting chronic pain have higher scores of depression assessed by patient health questionnaire-9. The presence of PHQ-9 scores above the 75th percentile is associated with the presence of self-reported chronic pain in hypertensive patients (B) and in hypertensive patients with impaired renal function (C).