Effects of opioid blockade with naltrexone and distraction on cold and ischemic pain in hypertension

Christopher Ring, Christopher R. France, Mustafa Al'Absi, Louise Beesley, Louisa Edwards, David McIntyre, Douglas Carroll, Una Martin

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Essential hypertension is characterised by reduced pain sensitivity. Hypertensive hypoalgesia has been attributed to elevated endogenous opioids and/or increased activation of descending pain modulation systems. A double-blind placebo-controlled design compared the effects of naltrexone and placebo on cold and ischemic pain in unmedicated newly-diagnosed patients with essential hypertension. Patients performed a cold pressor task while resting and while performing a distracting secondary task. They also performed a forearm ischemia task while resting. Although the cold pressor and ischemia tasks elicited significant increases in pain and blood pressure, pain ratings and pressor responses did not differ between naltrexone and placebo. Cold pain was reduced by distraction compared to rest. The finding that opioid blockade with naltrexone did not moderate the pain and pressor responses to cold and ischemia suggests that pain and associated blood pressure responses are not modulated by opioids in hypertension. The finding that the distracting secondary task successfully reduced pain ratings suggests normal supraspinal pain modulation in essential hypertension.

Original languageEnglish (US)
Pages (from-to)59-68
Number of pages10
JournalJournal of Behavioral Medicine
Issue number1
StatePublished - Feb 2007

Bibliographical note

Funding Information:
This study was supported by NIH grant R01 HL64794. L. E. is a British Heart Foundation Fellow (FS/03/128).


  • Distraction
  • Endogenous opioids
  • Hypertension
  • Hypoalgesia
  • Naltrexone
  • Pain


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