ArticlePain reports
The indirect impact of heart rate variability on cold pressor pain tolerance and intensity through psychological distress in individuals with chronic pain: the Tromsø Study.
Article in Pain reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Heart Rate Variability Mediates the Association Between Fear of Pain and Pain Perception: An Exploratory Study in Healthy Controls.Journal of clinical medicine · 2026Article
- A Novel Investigation of an In-Scanner Alternative to the Cold Pressor Test in Healthy Individuals.Human brain mapping · 2025Article
- Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review.Frontiers in systems neuroscience · 2023Review
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionChronic pain (CP) patients often display lower heart rate variability (HRV) and baroreceptor sensitivity (BRS), which are associated with increased evoked pain intensity and decreased pain tolerance.
objectiveThe purpose of this study was to test whether the association between low levels of HRV and BRS and increased evoked pain responsiveness in individuals with CP is mediated by psychological distress and whether this mediation is sex dependent.
methodsThe sample consisted of 877 participants in Wave 6 of the Tromsø population study who reported clinically meaningful CP. Resting HRV and BRS parameters were derived from continuous beat-to-beat blood pressure recordings. Psychological distress was assessed using the Hopkins Symptom Checklist-10. After cardiovascular assessment, participants completed a 106-second cold pressor task (3°C bath), which assessed cold pressor pain intensity (CPI) and cold pressor pain tolerance (CPT).
resultsIn the full CP sample, mediation analyses showed significant indirect effects, without direct effects, of HRV and BRS on both CPT and CPI via psychological distress. When stratified by sex, significant indirect effects via psychological distress were only found in males for the impact of rMSSD on CPT, the impact of SDNN on CPT, and the impact of BRS on CPT via psychological distress. Moderated mediation analyses revealed that there were no significant sex differences in the indirect effects of HRV and BRS on both CPT and CPI via psychological distress.
conclusionsThe hypoalgesic impact of cardiovascular regulatory systems on evoked pain responses is conveyed via the indirect effects of psychological distress.
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