The Influence of Low Blood Pressure and Baroreceptor Activity on Pain Responses

doi:10.1016/S0031-9384(97)00039-5

Physiology & Behavior

Volume 62, Issue 2, August 1997, Pages 391-397

https://doi.org/10.1016/S0031-9384(97)00039-5 Get rights and content

Abstract

Angrilli, A., A. Mini, R. F. Mucha and H. Rau. The influence of low blood pressure and baroreceptor activity on pain responses. Physiol Behav 62(2) 391–397, 1997.—The influence of baroreceptor modulation on pain perception has been extensively studied in normal and hypertensive subjects, but not in hypotensive subjects. The present experiment was performed to verify the following hypotheses: 1. Hypotensive subjects exhibit an increased pain response following baroreceptor activation compared to normals; 2. unlike the hypotensives, normal subjects, with normal baroreceptor reflexes, would learn to choose more often the baroreceptor activation condition compared to the opposite condition, during painful stimulation; 3. sensory and pain thresholds are correlated with blood pressure. The subjects (39 men), divided according to low and normal blood-pressure groups, participated in an experiment in which electrically-induced pain ratings and pain-evoked potentials were measured. Baroreceptor manipulation was performed by means of the PRES procedure. Whereas hypotensive subjects did not perceive any pain difference between the two baroreceptor conditions, activation and inhibition, normotensive men were able to perceive the baroreceptor activation condition as less painful. Similarly to subjective ratings, pain-evoked potentials of the low blood-pressure group showed a reversed trend compared to normals: larger somatosensory evoked potentials (N150-P260) to the baroreceptor activation condition and the opposite to the baroreceptor deactivation condition. Furthermore, results showed a negative correlation between diastolic blood pressure and sensory perception threshold, and a positive correlation between systolic pressure and pain threshold. Contrary to expectations, the rate of choice of baroreceptor conditions during painful stimulation did not show, in either group, any preference for baroreceptor activation.

Section snippets

Subjects

Subjects were 39 men (mean age: 25.3 ± 4.6, range: 18–40 years) recruited from the University of Tübingen (Germany) main refectory.

They were subjected to 9 BP measurements and then split into 2 equally sized groups, according to the mean systolic BP. The low BP group consisted of 19 subjects (systolic BP 116.9 ± 6.1 mmHg; diastolic BP 74.27 ± 7.0 mmHg) and the normal BP group, 20 (systolic BP 135.3 ± 7.2 mmHg; diastolic BP 78.0 ± 7.6 mmHg).

All subjects signed a consent form summarizing the

Sensory and Pain Thresholds

There was a negative correlation between diastolic BP and sensory threshold (r = −0.435, p < 0.006; without the most extreme point r = −0.478, p < 0.003).

Furthermore, a positive correlation (r = 0.266, p < 0.106; without the most extreme point r = 0.369, p < 0.02) was found between systolic BP and pain threshold.

However, the correlations between systolic BP and sensory threshold (r = 0.107; without the most extreme point r = 0.047), and between diastolic BP and pain threshold (r = −0.034;

Discussion

Overall, the results showed a different pattern of pain processing in hypotensives. The difference was observed at more levels. Both self-reported pain ratings and somatosensory potentials evoked during baroreceptor activation showed a lack of the pain inhibition typically observed in normotensive and hypertensive subjects. Furthermore, the different correlations found between perceptual/pain thresholds and systolic/diastolic blood pressure let us hypothesize the existence of a different

Acknowledgements

This work was supported by the Deutsche Forschungsgemeinschaft and by Vigoni Program to the first author.

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View full text

The Influence of Low Blood Pressure and Baroreceptor Activity on Pain Responses

Abstract

Section snippets

Subjects

Sensory and Pain Thresholds

Discussion

Acknowledgements

J. Psychosom. Res.

Biol. Psychol.

Physiol. Behav.

Electroencephal. Clin. Neurophysiol.

Int. J. Psychophysiol.

Brain Res.

Activation of carotid sinus baroreceptors reduces pain sensations evoked by electrical and cold stimulation of human teeth

Proc. Finn. Dent. Soc.

Behavioral induction of arterial hypertension and its reversal

Am. J. Physiol.

Hypertension as a learned response: the baroreceptor reinforcement hypothesis

The baroreceptor reinforcement instrumental learning (BR-IL) model of essential hypertension: biological data, quantitative mechanisms, and computer modeling

Baroreceptor activation reduces reactivity to noxious stimulation: implications for hypertension

Science

Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception

Proc. Nat. Acad. Sci.

A simplified neck suction device for activation of carotid baroreceptors

J. Lab. Clin. Med.

Sensory effects of baroreceptor activation and perceived stress together predict long-term blood pressure elevation

Int. J. Behav. Med.

Modulation of slow cortical potentials by instrumentally learned blood pressure responses

Psychophysiology

Baroreceptor stimulation alters pain sensation depending on tonic blood pressure

Psychophysiology

Is elevated blood pressure level associated with higher cardiovascular responsiveness in laboratory tasks and with response specificity?

Psychophysiology

Cognitive processes in hypertension

Hypertension