Day: November 24, 2025

Categories : Cardiovascular DiseaseTags :

Chronic Pain May Increase Hypertension Risk in Adults

On By ModernMedia

Depression resulting from pain may be a contributing factor in the development of high blood pressure, finds a new study

Credit: Pixabay CC0

Chronic pain in adults may increase their risk of high blood pressure, and the location and extent of pain and if they also had depression were contributing factors, according to new research published in Hypertension, an American Heart Association journal.

An analysis of health data for more than 200 000 adults in the US found that those who reported chronic pain throughout their bodies were more likely to develop high blood pressure than people who reported no pain, short-term pain or pain limited to specific areas.

“The more widespread their pain, the higher their risk of developing high blood pressure,” said lead study author Jill Pell, MD, CBE, Professor of Public Health at the University of Glasgow. “Part of the explanation for this finding was that having chronic pain made people more likely to have depression, and then having depression made people more likely to develop high blood pressure. This suggests that early detection and treatment of depression, among people with pain, may help to reduce their risk of developing high blood pressure.”

High blood pressure and hypertension occurs when the force of blood pushing against the walls of blood vessels is too high, and it increases the risk of heart attack or stroke. High blood pressure as well as stage one or stage two hypertension, which includes blood pressure measures from 130/80mmHg to 140/90mmHg or higher, affects nearly half of all adults in the US, and is the leading cause of death in the US and around the world, according to the 2025 joint American Heart Association/American College of Cardiology guideline endorsed by 11 other organisations.

According to previous research, chronic musculoskeletal pain – pain in the hip, knee, back or neck/shoulder that lasts for at least three months – is the most common type of pain in the general population. This study investigated the associations between the type, location and extent of pain throughout the body and the development of high blood pressure.

Inflammation and depression are both known to raise the risk of high blood pressure; however, no prior studies have examined the extent to which the link between pain and high blood pressure is mediated through inflammation and depression, Pell said.

In this study, participants completed a baseline questionnaire and provided information about whether they had experienced pain in the last month that interfered with their usual activities. They noted if the pain was in their head, face, neck/shoulder, back, stomach/abdomen, hip, knee or all over their body. If they reported pain, they indicated whether pain had persisted for more than three months.

Depression was gauged based on participants’ responses to a questionnaire that asked about the frequency of depressed mood, disinterest, restlessness or lethargy in the previous two weeks. Inflammation was measured with blood tests for C-reactive protein (CRP).

After an average follow-up of 13.5 years, the analysis found:

  • Nearly 10% of all participants developed high blood pressure.
  • Compared to people who did not have pain, people with chronic widespread pain had the highest risk of high blood pressure (75% increased risk), while short-term pain was associated with a 10% higher risk and chronic localized pain was linked with a 20% higher risk.
  • When comparing sites of pain to people without pain, the analysis showed that chronic, widespread pain was associated with a 74% higher risk of developing high blood pressure; chronic abdominal pain with a 43% higher risk; chronic headaches with a 22% higher risk; chronic neck/shoulder pain with a 19% higher risk; chronic hip pain with a 17% higher risk; and chronic back pain with a 16% higher risk.
  • Depression (11.3% of participants) and inflammation (0.4% of participants) accounted for 11.7% of the association between chronic pain and high blood pressure.

“When providing care for people with pain, health care workers need to be aware that they are at higher risk of developing high blood pressure, either directly or via depression. Recognising pain could help detect and treat these additional conditions early,” Pell said.

Daniel W. Jones, MD, FAHA, chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline and dean and professor emeritus of the University of Mississippi School of Medicine in Jackson, Mississippi, said, “It is well known that experiencing pain can raise blood pressure in the short term, however, we have known less about how chronic pain affects blood pressure. This study adds to that understanding, finding a correlation between the number of chronic pain sites and that the association may be mediated by inflammation and depression.”

Jones, who was not involved in this research, suggests further exploration of the relationship through randomized controlled trials of approaches to pain management and blood pressure, especially the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen, which may also cause an increase in blood pressure.

“Chronic pain needs to be managed within the context of the patients’ blood pressure, especially in consideration of the use of pain medication that may adversely affect blood pressure,” said Jones.

The study’s limitations include that participants were middle- and older-aged adults who were mainly white people of British origin; therefore, the study’s findings may not be generalizable to people from other racial or ethnic groups, living in other countries or adults in other age groups. In addition, the information about levels of pain was self-reported, and the study relied on clinical diagnostic coding, a one-time pain assessment and two blood pressure measurements.

Study details, background and design:

  • The study reviewed data from the UK Biobank, a large population-based study that recruited more than 500 000 adults who were ages 40-69 when they joined the study between 2006 and 2010. Participants lived in England, Scotland and Wales.
  • This analysis included 206,963 adults. The average age of the participants was 54 years; 61.7% were women, and 96.7% were white adults.
  • Among all participants, 35.2% reported experiencing chronic musculoskeletal pain; 62.2% reported chronic pain at one site of the body; 34.9% reported chronic pain at two to three musculoskeletal sites; and 3.2% reported pain at four sites.
  • When compared with participants who reported no pain, participants reporting pain were more likely to be women, have an unhealthy lifestyle, larger waist circumference, higher body mass index (BMI), more long-term health conditions and live in areas with higher unemployment, lower home and car ownership and more overcrowding.
  • The researchers adjusted for factors associated with both pain and high blood pressure, including self-reported smoking status, alcohol consumption, physical activity, total sedentary time, sleep duration, and fruit and vegetable intake.
  • UK Biobank data was collected at the participants’ baseline appointment through a touch-screen questionnaire, interview, physical measurements (height, weight, BMI, waist circumference, blood pressure measurement) and blood samples taken for cholesterol and blood sugar (hemoglobin A1c).
  • The participants’ hospital records identified incidences of high blood pressure, which were defined using the standard International Statistical Classification of Diseases and Related Problems and diagnostic codes (ICD-10 codes).
  • The study’s follow-up duration was determined by measuring the time from the baseline date until one of the following events occurred: a recorded diagnosis of high blood pressure, the participant’s death or censoring due to reaching the end of follow-up records. The earliest of these events marked the end of the follow-up period for each participant.

Co-authors, disclosures and funding sources are listed in the manuscript.

Categories : Mental Health PaediatricsTags :

Social Media Use Drives Distrust Among Gen Z Teenage Girls

On By ModernMedia
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Social media use in adolescence is linked to delayed bedtimes, negative self-image and, especially among teenage girls, greater distrust, shows a new study from University College London. In turn, these changes are associated with more symptoms of depression and anxiety, risk of self-harm, and suicidal behaviours several years later. 

Published in Social Psychiatry and Psychiatric Epidemiology, the study examined how use of social media on the cusp of adolescence (11-years-old) was indirectly associated with a range of psychiatric symptoms, including psychological distress, self-harm and suicidal behaviours, in late adolescence (17-years-old). 

The study found three mechanisms linking social media use in early adolescence to small overall increases in subsequent mental health problems. Both boys and girls who were using social media from early on (at age 11) tended to sleep a little later on average, and had more negative thoughts about their physical appearance at age 14, compared to those who had not used social media. Crucially, teenage girls who had been using social media at age 11 reported greater distrust of other people at age 14.  

The three key mechanisms, which involved later bedtimes, more negative perceptions of body image, and distrust, mediated the association between early social media use and subsequent mental health problems. These small but significant relationships held true even after adjusting for socioeconomic and demographic factors, any maternal mental health problems, and children’s prior mental health difficulties (at age 7).  

The findings were based on data from the UK’s nationally representative Millennium Cohort Study, which was designed to track the lives of around 19 000 children born in 2000 to 2001 (and who belong to ‘Gen Z’, that is, children born between 1997 and 2012).  

During 2011-2012, at around age 11, the participants were asked: “How often do you visit a social networking website on the internet, such as Facebook or Bebo?”. Around three years later, they were followed up and asked about their usual bedtime, their trust in others, and their self-perception. A range of mental health challenges were subsequently tracked another three years later, at age 17. 

Lead author, Dr Dimitris Tsomokos (UCL Institute of Education) said: “These findings suggest that interpersonal distrust was a significant driver of psychiatric symptoms among Gen Z girls who used social media from early adolescence. 

“This distrust of others may be a particularly female response to the pressures of social media, which can sadly be fertile ground for social comparison, cyberbullying and perceived exclusion.” 

“We know that teenage girls display more empathetic concern and tend to place higher value on reciprocal relationships, and perhaps this is what drives greater distrust among them.” 

As policymakers and parents grapple with how to navigate technology use in childhood, the study’s authors recommend greater intervention in early adolescence, focused on fostering a sense of trust and social safety. They believe this can help mitigate the negative impacts of social media usage on young people’s long term mental health. 

Source: University College London

Categories : Cardiovascular DiseaseTags :

Low-dose Colchicine May Reduce Risk of Heart Attack and Stroke

On By ModernMedia

Researchers found that low-dose colchicine can be used to reduce heart attacks and strokes in high-risk patients

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A widely-used, inexpensive gout drug could reduce heart attacks and strokes in people with cardiovascular disease, according to a new Cochrane review.

The review examined the effects of low doses of colchicine, a drug used to treat gout, and found no increase in serious side effects.

Cardiovascular disease is often driven by chronic low-grade inflammation, which contributes to recurrent cardiovascular events such as heart attacks and strokes. Colchicine has anti-inflammatory properties that make it a promising option for people with heart disease. 

A promising effect on cardiovascular risk

The review included 12 randomised controlled trials involving nearly 23 000 people with a history of heart disease, heart attack or stroke. The studies looked at patients who took colchicine for at least six months, with doses of 0.5mg once or twice a day. Most participants were male (~80%) and the mean age was 57 to 74 years old. Half received colchicine, while the other half received either a placebo or no additional treatment alongside their usual care.

Overall, those taking low-dose colchicine were less likely to experience a heart attack or stroke. For every 1000 people treated, there were 9 fewer heart attacks and 8 fewer strokes compared with those not taking the drug. Whilst there were no serious adverse events identified, patients who took colchicine were more likely to have stomach or digestive side effects, but these were usually mild and didn’t last long.

Among 200 people with cardiovascular disease – where we would normally expect around seven heart attacks and four strokes – using low-dose colchicine could prevent about two of each. Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk.

– Dr Ramin Ebrahimi, co-lead author from the University Medicine Greifswald, Germany

A new use for a long-established medicine

As cardiovascular diseases are the leading cause of death globally, colchicine presents a promising inexpensive and accessible option for secondary prevention in high-risk patients.

These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use. It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks.

 – Lars Hemkens, senior author from the University of Bern, Switzerland

The evidence is less clear when it comes to whether colchicine affects overall death rates or the need for procedures like coronary revascularisation. The studies didn’t provide any information to say whether the drug improves quality of life or reduces hospital stays. The authors stress that further research is needed in these areas.

Source: Cochrane

Categories : HospitalsTags :

Asymptomatic Colonisers Drive the Spread of Drug-resistant Infections in Hospitals

On By ModernMedia

The computer model improves on traditional methods like contact tracing by inferring asymptomatic carriers in the spread of antibiotic-resistant infections

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A new analytical tool can improve a hospital’s ability to limit the spread of antibiotic-resistant infections over traditional methods like contact tracing, according to a new study led by researchers at Columbia University Mailman School of Public Health and published in the peer-reviewed journal Nature Communications. The method infers the presence of asymptomatic carriers of drug-resistant pathogens in the hospital setting, which are otherwise invisible.

Antimicrobial resistance (AMR) is an urgent threat to human health. In 2019, 5 million deaths were associated with an AMR infection globally.

The inference framework developed by Columbia Mailman School researchers is the first to combine several data sources – patient mobility data, clinical culture tests, electronic health records, and whole-genome sequence data – to predict the spread of an AMR infection in the hospital setting. In the study, the researchers used five years of real-world data from a New York City hospital. They focused on carbapenem-resistant Klebsiella pneumoniae (CRKP), an AMR bacterium with a high mortality rate. The framework draws on the four data sources to model the spread of CRKP infections, from individual to individual over time.

Levels of CRKP colonisation in healthcare facilities vary by location but can reach up to 22 percent of patients. However, hospitals do not routinely screen for CRKP, and surveillance relies on testing patients who are either symptomatic or suspected of coming into contact with symptomatic patients, overlooking asymptomatic colonisers.

“Many antimicrobial-resistant organisms colonise people without causing disease for long periods of time, during which these agents can spread unnoticed to other patients, healthcare workers, and even the general community,” says the study’s first author, Sen Pei, PhD, assistant professor of environmental health sciences at Columbia Mailman School. “Our inference framework better accounts for these hidden carriers.”

The researchers used the inference framework to estimate CRKP infection probabilities despite limited data on infections. They found that combining the four data sources led to more accurate carrier identification. Furthermore, using data simulations, they found that the framework was more successful at preventing the spread of infections after isolating carriers than traditional approaches based on an individual’s time in the hospital, the number of people they came in contact with, and/or whether the people they came in contact with were identified as having infections.

Using the inference model, isolating 1% of patients on the first day of each week (10–13 patients per week) reduces 16% of positive cases and 15% of colonisation; isolating 5% of patients on the first day of each week (50–65 patients per week) reduces 28% of positive cases and 23% of colonisation. For comparison, using contact tracing – a typical approach in clinical settings (ie, screening close contacts of positive patients) – isolating 1% of patients reduces 10% of positive cases and 8% of colonisation; isolating 5 percent of patients reduces 20% of positive cases and 16% of colonisation.

The new study builds on a study in PNAS that introduced a method that more accurately predicts the likelihood that individuals in hospital settings are colonised with methicillin-resistant Staphylococcus aureus (MRSA) than existing approaches. The new study is a significant advance over the previous study because it now includes patient-level electronic health records and whole-genome sequence data, which allows more precise identification of silent spreaders. While the inference model improves on traditional methods, it remains challenging to eliminate AMR pathogens in hospitals due to their widespread community circulation, limited hospital surveillance, and high false-negative rates in clinical culture tests. However, there is room for improvement; a future study aims to look at the spread of AMR using ultra-dense sequencing.

Source: Columbia University Mailman School of Public Health

Categories : HIVTags :

Trial Results Shows the Value of Patient Navigation in Humanising HIV Care

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Eastern Cape HIV Programme demonstrates success in resource-constrained setting

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A new randomised controlled trial conducted in the Eastern Cape has shown that adding structured patient navigation to same-day antiretroviral therapy (ART) can make a meaningful difference for people newly diagnosed with HIV. The trial found that patients who received support from trained navigators were far more likely to stay in care and keep their viral load low over six months. Those with navigator support had a 79% retention rate, compared with 64% under standard care.

Among patients who achieved a viral load of fewer than 50 copies per millilitre, 64% remained in care, compared to just 39% without this extra support(1). Patient navigation combines personal support, such as home or virtual check-ins and WhatsApp reminders, with practical help like linking people to services and monitoring their progress. It was especially effective for people who started treatment on the same day as their diagnosis.

“This approach humanises HIV care. It builds a bridge between the clinic and the community, helping patients stay connected to treatment and ultimately saving lives,” said lead author Siyakudumisa Nontamo, Facility Team Lead: Care & Treatment Programme at TB HIV Care.

In August 2024 the Human Sciences Research Council released findings from the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the Eastern Cape. The results show that HIV prevalence in the province stabilised, moving from 15.9% in 2017 to 13.7% in 2022. This is an estimated 980 000 people living with HIV, down from about 1 million in 2017. Access to treatment has improved significantly. ART coverage increased from 67.8% in 2017 to 83.5% in 2022, meaning about 723 000 people in the province are now receiving treatment. However, gaps remain among young people: only 70.9% of adolescents and youth aged 15–24 living with HIV are on ART, compared to 84.8% of adults aged 25-49. Among females, coverage is much lower for young women (68.7%) than for women aged 25-49 (88.2%). ART use also varies across districts, ranging from 69.4% in Nelson Mandela Bay to 92.0% in Alfred Nzo(2). Nationally, the proportion of people living with HIV who are currently on antiretroviral treatment (ART) rose to 80.9% in 2022, up from 63.7% in 2017.

Despite major advances in antiretroviral therapy, retention in care remains a persistent challenge within South Africa’s HIV programme, especially in rural provinces such as the Eastern Cape. Many patients initiate treatment but later disengage due to stigma, transport difficulties, and limited ongoing support. The study shows that low-cost, human-centred interventions can significantly strengthen treatment outcomes. The trial, titled “Impact of Patient Navigation on Retention in Care and HIV Viral Load Suppression Among Newly Diagnosed Persons Living with HIV in the Eastern Cape,” compared standard HIV care to an approach where trained patient navigators provided ongoing support to patients starting antiretroviral therapy (ART). Beyond improved retention and viral suppression, the trial also showed that patients supported by navigators experienced fewer deaths and dropouts, with substantially lower losses to follow-up and reduced mortality than those receiving standard care, ultimately strengthening HIV programmes(1).

Patient navigation, in particular, helps bridge the gap by pairing practical healthcare coordination with empathy and community-based follow-up. Navigators assist patients with managing appointments, maintaining adherence, and accessing psychosocial services, thereby fostering trust, continuity, and sustained engagement in care. This approach aligns with South Africa’s national HIV strategy, which prioritises differentiated, patient-centred models of care to achieve the UNAIDS 95-95-95 targets.

At scale, TB HIV Care’s programmes are grounded in person-centred, integrated service models that reflect the real lives and needs of people affected by HIV and TB. This study reinforces TB HIV Care’s belief that support beyond clinic walls is essential for achieving lasting impact. In the 2024/25 reporting period, the organisation reached more than 1.9 million people with HIV testing services and initiated 27,873 individuals on ART, achieving a 95% viral suppression rate among clients in care.

“By bridging the gap between diagnosis and ongoing care, patient navigation aligns with our outreach for key populations and our shift toward holistic service delivery. We look forward to translating this evidence into practice, ensuring fewer people fall through the cracks and more sustain treatment success”, said Professor Harry Hausler, CEO at TB HIV Care.

Additional findings from the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the Eastern Cape.

  • In the Eastern Cape, HIV remains most common among adults aged 25-49, with a prevalence of 27.7%, and women in this age group are especially affected at 35.4% compared to 17.1% for men.
  • The survey also found geographic differences: HIV prevalence among men was highest in urban areas (8.7%), while among women it was highest in rural informal or tribal areas (19.8%).
  • By district, prevalence was highest in Chris Hani (14.4%), Amathole (14.1%), Alfred Nzo (13.9%), and lowest in Nelson Mandela Bay (9.7%).
  • At a national level, the survey showed that 81.4% of all people living with HIV were virally suppressed. The survey found encouraging progress in the Eastern Cape, where viral load suppression (VLS) among people living with HIV rose to 79.3% in 2022, up from 66.3% in 2017. However, children aged 0-14 years had much lower suppression levels, at 61.4%. Among people aged 15-49 years living with HIV, 78.6% were virally suppressed. Within this group, women had far higher suppression rates (83.9%) than men (65.4%).

About the Randomized Controlled Trial

The randomised controlled trial involved participants from HIV testing sites in the O.R. Tambo District (Flagstaff, Mthatha Gateway, and Tsolo Clinics). It was approved by the Eastern Cape Health Research Committee and Walter Sisulu University’s Ethics Committee. The study was supported by the Chemical Industries Education and Training Authority (CHIETA) and the South African Medical Research Council’s Strategic Health Innovation Partnerships (SHIP).

References:

  1. Nontamo, S., Kamsu, G.T., Ndebia, E.J., et al. Impact of Patient Navigation on Retention in Care and HIV Viral Load Suppression Among Newly Diagnosed Persons Living with HIV in the Eastern Cape – South Africa. Access.
  2. Human Sciences Research Council. Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI). Access.