| The relationship between resting blood pressure and acute pain sensitivity: effects of chronic pain and alpha-2 adrenergic blockade. | |
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MedLine Citation:
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PMID: 17940860 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study tested for alpha-2 adrenergic mediation of the inverse relationship between resting blood pressure and acute pain sensitivity in healthy individuals. It also replicated limited prior work suggesting this inverse blood pressure/pain association is altered in chronic pain, and provided the first test of whether chronic pain-related changes in alpha-2 adrenergic function contribute to these alterations. Resting blood pressure was assessed in 32 healthy controls and 24 chronic low back pain participants prior to receiving placebo or an intravenous alpha-2 adrenergic receptor antagonist (yohimbine hydrochloride, 0.4 mg/kg) in a randomized crossover design. Participants experienced three acute pain tasks during both sessions. A significant Systolic Blood Pressure x Participant Type x Drug interaction on finger pressure McGill Pain Questionnaire-Sensory ratings (P < .05) reflected significant hyperalgesic effects of yohimbine in chronic pain participants with lower systolic blood pressures (P < .05) but not those with higher systolic pressures, and no significant effects of yohimbine in controls regardless of blood pressure level. A Drug x Systolic Blood Pressure interaction on finger pressure visual analog scale unpleasantness indicated the inverse blood pressure/pain association was significantly stronger under yohimbine relative to placebo (P < .05). Significant Participant Type x Systolic Blood Pressure interactions (P's < .05) were noted for finger pressure visual analog scale pain intensity and unpleasantness, ischemic pain threshold, and heat pain threshold, reflecting absence or reversal of inverse blood pressure/pain associations in chronic pain participants. Results suggest that blood pressure-related hypoalgesia can occur even when alpha-2 adrenergic systems are blocked. The possibility of upregulated alpha-2 adrenergic inhibitory function in chronic pain patients with lower blood pressure warrants further evaluation. |
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Authors:
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Stephen Bruehl; Ok Y Chung; Laura Diedrich; André Diedrich; David Robertson |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2007-10-17 |
Journal Detail:
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Title: Journal of behavioral medicine Volume: 31 ISSN: 1573-3521 ISO Abbreviation: J Behav Med Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-04-08 Completed Date: 2009-04-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7807105 Medline TA: J Behav Med Country: United States |
Other Details:
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Languages: eng Pagination: 71-80 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Vanderbilt University School of Medicine, 701 Medical Arts Building, 1211 Twenty-First Avenue South, Nashville, TN 37212, USA. Stephen.Bruehl@vanderbilt.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adrenergic alpha-Antagonists / administration & dosage* Adult Blood Pressure / physiology* Chronic Disease Cross-Over Studies Double-Blind Method Female Fingers Hot Temperature Humans Hyperalgesia / physiopathology Male Middle Aged Pain / physiopathology* Pressure Receptors, Adrenergic, alpha-2 / antagonists & inhibitors*, physiology Yohimbine / administration & dosage* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR-00095/RR/NCRR NIH HHS; NS046694/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Antagonists; 0/Receptors, Adrenergic, alpha-2; 146-48-5/Yohimbine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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