Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct;24(10):385-394.
doi: 10.1007/s11906-022-01205-5. Epub 2022 Jun 15.

The Effects of Pain and Analgesic Medications on Blood Pressure

Giulia Rivasi  1 , Silvia Menale  2 , Giada Turrin  2 , Antonio Coscarelli  2 , Antonella Giordano  2 , Andrea Ungar  2
Affiliations
Review

The Effects of Pain and Analgesic Medications on Blood Pressure

Giulia Rivasi et al. Curr Hypertens Rep. 2022 Oct.

Abstract

Purpose of review: To review the blood pressure (BP) effects of pain and analgesic medications and to help interpret BP changes in people suffering from acute or chronic pain.

Recent findings: Acute pain evokes a stress response which prompts a transient BP increase. Chronic pain is associated with impaired regulation of cardiovascular and analgesia systems, which may predispose to persistent BP elevation. Also analgesics may have BP effects, which vary according to the drug class considered. Data on paracetamol are controversial, while multiple studies indicate that non-steroidal anti-inflammatory drugs may increase BP, with celecoxib showing a lesser impact. Hypotension has been reported with opioid drugs. Among adjuvants, tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors could be pro-hypertensive due to potentiation of adrenergic transmission. Pain and analgesics may induce a clinically significant BP destabilization. The implications on hypertension incidence and BP control remain unclear and should be explored in future studies.

Keywords: Blood pressure control; Hypertension; NSAIDs; Opioids; Paracetamol.

PubMed Disclaimer

Conflict of interest statement

Giulia Rivasi, Silvia Menale, Giada Turrin, Antonio Coscarelli, Antonella Giordano, and Andrea Ungar have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Physiology of pain and analgesia. CNS, central nervous system
Fig. 2
Fig. 2
The effects of acute and chronic pain on blood pressure
See this image and copyright information in PMC

References

    1. IASP Terminology. Descriptions of chronic pain syndromes and definitions of pain terms [Internet]. 2011. Available from: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698&navItem.... Accessed 1 Aug 2021.
    1. Hasselström J, Liu-Palmgren J, Rasjö-Wrååk G. Prevalence of pain in general practice. Eur J Pain [Internet]. 2002;6(5):375–85. Available from: http://doi.wiley.com/10.1016/S1090-3801%2802%2900025-3. Accessed 1 Aug 2021. - DOI - PubMed
    1. Gregory J, McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. J Clin Nurs [Internet]. 2016;25(5–6):583–98. Available from: http://doi.wiley.com/10.1111/jocn.13094. Accessed 1 Aug 2021. - DOI - PubMed
    1. Dahlhamer J, Lucas J, Zelaya, C, Nahin R, Mackey S, DeBar L, et al. Prevalence of chronic pain and high-impact chronic pain among adults — United States, 2016. MMWR Morb Mortal Wkly Rep [Internet]. 2018;67(36):1001–6. Available from: http://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm?s_cid=mm6736a2_w. Accessed 1 Aug 2021. - PMC - PubMed
    1. Breivik H, Eisenberg E, O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health [Internet]. 2013;13(1):1229. Available from: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1229. Accessed 1 Aug 2021. - DOI - PMC - PubMed

Publication types

MeSH terms