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Olesen TB, Glintborg D, Jøhnk F, Olsen MH, Andersen MS. Blood pressure responses to testosterone therapy are amplified by hematocrit levels in opioid-induced androgen deficiency: a double-blind, randomized, placebo-controlled trial. J Hypertens 2024; 42:893-901. [PMID: 38088425 DOI: 10.1097/hjh.0000000000003638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Our study aimed to examine the effect of testosterone replacement therapy (TRT) on blood pressure in opioid-treated men with relative hypogonadism, and whether the effect of TRT on blood pressure was modified by body composition, red blood cell levels, or carotid intima media thickness. Men (over 18 years old) receiving opioid treatment and total testosterone less than 12 nmol were randomly assigned to receive either TRT or placebo. Baseline and 6-month measurements included anthropometric measurements, office blood pressure (OBPM), 24-h ambulatory blood pressure, blood samples, and carotid ultrasound. The mean systolic OBPM increased by 6.2 mmHg (0.2-12.1) in the TRT group and decreased by 7.0 mmHg (1.0-15.1) in the placebo group, with a mean difference of 13.2 mmHg (3.4-23.1), P = 0.01. In the TRT group, a 10 mmHg increase in systolic OBPM was associated with an increase in hematocrit of 0.3% points (0.1-0.5) ( P = 0.01), whereas no association was observed in the placebo group ( P = 0.266). Daytime SBP showed a nonsignificant increase of 5.2 mmHg (-1.7, 12.1) ( P = 0.134) in the TRT group compared to that in the placebo group. However, the impact of TRT on the increase in daytime ambulatory blood pressure was significantly accentuated by baseline values of BMI, hematocrit, and hemoglobin. In conclusion, TRT was associated with higher OBPM compared to placebo, and the increase in blood pressure was linked to higher hematocrit during TRT. Our data suggest that men with opioid-induced androgen deficiency, particularly those with obesity or red blood cell levels in the upper normal range, are more susceptible to increased daytime SBP during TRT.
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Affiliation(s)
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense
| | - Frederik Jøhnk
- Department of Internal Medicine, Sygehus Lillebaelt, Kolding
| | - Michael Hecht Olsen
- Department of Internal Medicine, Cardiology Section, Holbaek Hospital, Holbaek, Denmark
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Adamo D, Canfora F, Calabria E, Coppola N, Sansone M, Spagnuolo G, Pecoraro G, Aria M, D’Aniello L, Mignogna MD, Leuci S. Burning Mouth Syndrome and Hypertension: Prevalence, Gender Differences and Association with Pain and Psycho-Social Characteristics-A Case Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2040. [PMID: 36767407 PMCID: PMC9916056 DOI: 10.3390/ijerph20032040] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND To assess the prevalence of hypertension (HTN) in burning mouth syndrome (BMS) patients and to investigate its relationship with sociodemographic factors, pain and the psychological profile. METHODS A case-control study was conducted by enrolling 242 BMS patients and 242 controls matched for age and gender. Sociodemographic and clinical characteristics were recorded, and all participants completed numeric rating scale (NRS), the short-form of the McGill pain questionnaire (SF-MPQ), the Hamilton rating scale for anxiety and depression (HAM-A, HAM-D), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS). RESULTS The BMS patients presented with a statistically significant higher prevalence of HTN compared to that in the controls (55% versus 33.5%; p-value: <0.001) and higher median scores of the NRS, SF-MPQ, HAM-A, HAM-D, PSQI and ESS (p < 0.001). Multivariate regression analysis in the BMS patients indicated positive correlations between HTN and age, systemic diseases, drug consumption and anxiety (p-value: <0.001) and these predictors were responsible for 11.3% of the HTN variance in the BMS patients, when considered together. CONCLUSIONS The prevalence of HTN was significantly higher in the BMS patients, since ageing, the presence of comorbidities, drug consumption and anxiety were potential predictors. Further studies are needed to better investigate the relationship between BMS and HTN.
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Affiliation(s)
- Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Elena Calabria
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Mattia Sansone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow 119991, Russia
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, 80138 Naples, Italy
| | - Luca D’Aniello
- Department of Social Sciences, University Federico II of Naples, 80138 Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
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Won MH, Son YJ. Combined influence of sedentary behaviours and chronic pain on depressive symptoms in older Korean adults with hypertension. Eur J Cardiovasc Nurs 2022; 21:791-800. [PMID: 35285897 DOI: 10.1093/eurjcn/zvac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/29/2021] [Accepted: 02/25/2022] [Indexed: 12/29/2022]
Abstract
AIMS Depressive symptoms in hypertensive patients are linked to poor adherence to treatment. Sedentary behaviours and chronic pain can increase blood pressure and depressive symptoms, respectively. However, the impact of their coexistence on depressive symptoms in older adults with hypertension has not yet been investigated. This study aimed to identify the combined influence of sedentary behaviours and chronic pain on depressive symptoms in older adults with hypertension in Korea. METHODS AND RESULTS This cross-sectional study used data from the sixth Korea National Health and Nutrition Examination Survey from January to December 2014. The survey adopted multistage stratified sampling by geographical region, gender, and age. For the data analysis, a total of 573 patients with hypertension aged 65 years or older were included. Approximately, 61.0% of depressed older patients had both sedentary behaviours and chronic pain compared with patients without depressive symptoms. In multivariate logistic regression analysis, compared with patients without either sedentary behaviours or chronic pain, older adults with hypertension who presented both sedentary behaviours, and chronic pain had the highest risk of depressive symptoms (odds ratio = 13.86, 95% confidence interval = 5.87-32.71; P < 0.001). CONCLUSION Coexistence of sedentary behaviours and chronic pain in older hypertensive patients may lead to depressive symptoms. Evaluating both sedentary behaviours and chronic pain when assessing depressive symptoms in patients with hypertension would be beneficial in planning a patient-centred approach for controlling blood pressure. More prospective cohort studies with larger samples are required to identify the causal relationships.
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Affiliation(s)
- Mi Hwa Won
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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Patterns of patient outcomes following specialist pain management in Australasia: a latent class analysis using the ePPOC database. Pain 2022; 164:967-976. [PMID: 36448970 DOI: 10.1097/j.pain.0000000000002799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/23/2022] [Indexed: 12/05/2022]
Abstract
ABSTRACT The increasing demand for pain management and limited resources available highlight the need to measure treatment effectiveness. We analysed data collected at 75 specialist persistent pain services located in Australia and New Zealand to calculate overall treatment outcome for patients receiving care during 2014-2020. Socio-demographic and clinical information was provided for 23,915 patients, along with patient-reported measures assessing pain, pain interference, depression, anxiety, stress, pain catastrophizing and pain self-efficacy. Latent Class Analysis identified four distinct outcomes based on patients' pattern of responses across the assessment tools at treatment end. Group 1 (n=8,369, 35%) reported low/mild severity across all clinical domains at the end of care, while Group 4 (n= 7,081, 30%) were more likely to report moderate/high severity on all domains. Group 2 (n=1,991, 8%) reported low/mild pain with moderate/high psychological distress at treatment end, and Group 3 (n=6,474, 27%) reported moderate/high pain with low/mild psychological distress. Multi-variable logistic regression identified those factors associated with the different groups. In particular, factors most predictive of a poor (Group 4) vs. good outcome (Group 1) were unemployment (due to pain or other reasons), requiring an interpreter, widespread pain, pain of longer duration and attributing the pain to an injury at work. The results may allow identification of those most likely to benefit from the services currently provided, and inform development of alternative or enhanced services for those at risk of a poor outcome.
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Headache Disorders: Does Pain Affect Blood Pressure? Curr Pain Headache Rep 2022; 26:821-826. [PMID: 36251159 DOI: 10.1007/s11916-022-01083-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The perspective that pain corresponds to elevated blood pressure is overly simplistic. Our objective is to investigate and debunk misconceptions regarding the effect of pain on blood pressure. RECENT FINDINGS While pain can increase blood pressure in the acute setting, prolonged pain and migraine's effect on blood pressure varies and can result in lower-than-expected blood pressure. Therefore, attributing pain as a sole source of elevation of blood pressure may lead to delays in diagnosing hypertension. Based on limited studies available, comorbid pain and chronic hypertension have a higher concurrence than in the general population. We will review current literature to investigate the effect of pain on blood pressure and prevalence of hypertension in chronic pain sufferers. A better understanding of pain's effect on blood pressure will help practitioners appropriately diagnose and counsel patients without disproportionately attributing high blood pressure to pain.
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Prevalence of pain in community-dwelling older adults with hypertension in the United States. Sci Rep 2022; 12:8387. [PMID: 35589916 PMCID: PMC9119929 DOI: 10.1038/s41598-022-12331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
Hypertension and pain are both prevalent conditions in the older adult population. We aimed to report the prevalence of pain discomforts and investigated the association between hypertension and pain discomforts among older adults in the United States. Data from the 2011 National Health and Aging Trends Study were analyzed. In-person interviews were conducted in 7601 adults ages ≥ 65 years. Prevalence of bothersome pain, activity-limiting pain, locations of pain and usage of pain medicine were evaluated. Demographics, comorbidities, and other covariates were compared between older adults with hypertension and those without. Multivariate regression was further performed to yield adjusted odd ratios. Among 6825 older adults, 4533 of them had a history of hypertension while 2272 of them had not. Prevalence of bothersome pain (57.12% versus 44.81%, p < 0.001) and activity-limiting pain (56.21% versus 46.12%, p < 0.001) were significantly higher in the hypertension group. After adjusting for all covariates, hypertension demonstrated a significant association with activity-limiting pain (OR 1.63, 95% CI 1.06 to 2.52, p = 0.02). In conclusion, pain was more prevalent in older Americans with hypertension. The positive association between hypertension and pain suggested that routine pain assessment and proper treatment would be required to improve the function and quality of life among older adults especially with hypertension.
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Hamam MS, Kunjummen E, Hussain MS, Nasereldin M, Bennett S, Miller J. Anxiety, Depression, and Pain: Considerations in the Treatment of Patients with Uncontrolled Hypertension. Curr Hypertens Rep 2020; 22:106. [PMID: 33170388 DOI: 10.1007/s11906-020-01117-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW The association between mental health, pain, and treatment-resistant hypertension is an important consideration for treating physicians. We review and discuss the connection between conditions of anxiety, depression, and chronic pain and their effect on uncontrolled hypertension. RECENT FINDINGS There is significant co-occurrence of hypertension with anxiety, depression, and chronic pain which may lead to undertreatment of hypertension and undertreatment of the underlying mental health disorder. The association between mental health and hypertension is complex and is modulated by physiologic and environmental factors. Physicians treating patients with hypertension should be cognizant of the role anxiety, depression, and chronic pain play in treatment efficacy and compliance. Patients undergoing treatment should be screened for mental health disorders at treatment initiation and frequently thereafter to ensure optimal overall health and compliance.
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Affiliation(s)
| | | | | | | | | | - Joseph Miller
- Henry Ford Hospital, Emergency Medicine, Detroit, MI, 48202, USA. .,Wayne State University, Detroit, MI, 48202, USA.
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Li TT, Xiong LL, Huang J, Wen S, Chen YJ, Wang TH, Liu F. The Effects of Body Mass Index on the Use of Patient-Controlled Intravenous Analgesia After Open Gastrointestinal Tumor Surgery: A Retrospective Analysis. J Pain Res 2020; 13:2673-2684. [PMID: 33116809 PMCID: PMC7588277 DOI: 10.2147/jpr.s261997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/28/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose To investigate the impact of body mass index (BMI) on the analgesic effects and adverse reactions of patient-controlled intravenous analgesia (PCIA). Methods From 2017 to 2018, 390 patients undergoing open gastrointestinal surgery were reviewed at West China Hospital, Sichuan University. All used PCIA of sufentanil combined with dexmedetomidine and flurbiprofen axetil. According to their BMIs, they were placed into six groups: group A (BMI < 18.5kg/m2, 29), group B (18.5kg/m2 ≤ BMI< 22kg/m2, 124), group C (22kg/m2 ≤ BMI < 24kg/m2, 99), group D (24kg/m2 ≤ BMI < 26kg/m2, 69), group E (26kg/m2 ≤ BMI < 28kg/m2, 46) and group F (BMI ≥28kg/m2, 23). Main data of the perioperative use of analgesics, postoperative visual analogue score (VAS), and adverse reactions were collected. Results Twenty-four hours (h) after surgery, patients in group A had a higher resting VAS than the other groups, especially B (pA-B = 0.011). VAS of patients during activity in group B was lower than those in group C 48 h after surgery (p = 0.013). Compared with groups B to F, group A had a significantly lower incidence of hypertension (p = 0.012) and a significantly higher incidence of vomiting 24 h after surgery (p = 0.009). Binary logistic analysis found that higher age was a risk factor for vomiting 24 h after surgery (OR 1.158, p = 0.045). Conclusion Using the same PCIA, patients with BMIs of less than 18.5 kg/m2 had worse analgesia on the first day after surgery and were more likely to vomit. Postoperative analgesia and related experiences in patients with BMIs of less than 18.5 kg/m2 need to be improved.
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Affiliation(s)
- Ting-Ting Li
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Liu-Lin Xiong
- School of Pharmacy and Medical Sciences, Faculty of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Jin Huang
- Laboratory Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, People's Republic of China
| | - Song Wen
- Department of Pain, Affiliated Hospital of Zunyi Medical University, Guizhou, People's Republic of China
| | - Yan-Jun Chen
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Ting-Hua Wang
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
| | - Fei Liu
- Department of Anesthesiology, Institute of Neurological Disease, West China Hospital, Sichuan University, Chengdu, 610044, People's Republic of China
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Glare P, Costa D, Nicholas M. Psychosocial characteristics of cancer-related pain in patients attending specialist pain clinics in Australia and New Zealand. Psychooncology 2020; 29:2097-2100. [PMID: 32658321 DOI: 10.1002/pon.5474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/25/2020] [Accepted: 07/04/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Paul Glare
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Costa
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Michael Nicholas
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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