Psychosomatic Medicine Faster Service from Outside North America
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by al'Absi, M.
Right arrow Articles by Wittmers, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by al'Absi, M.
Right arrow Articles by Wittmers, L.
Related Collections
Right arrow Blood Pressure
Right arrow Endocrinology
Right arrow Pain
Psychosomatic Medicine 68:292-298 (2006)
© 2006 American Psychosomatic Society

ORIGINAL ARTICLES

Adrenocortical and Nociceptive Responses to Opioid Blockade in Hypertension-Prone Men and Women

Mustafa al'Absi, PhD, Christopher France, PhD, Angie Harju, BS, Janis France, PhD and Lorentz Wittmers, MD, PhD

From the Departments of Behavioral Sciences (M.A., A.H.), Family Medicine (M.A.), and Physiology & Pharmacology (M.A., L.W.), University of Minnesota Medical School, Duluth, MN; and the Department of Psychology (C.F., J.F.), Ohio University, Athens, OH.

Address correspondence and reprint requests to Mustafa al'Absi, PhD, Department of Behavioral Sciences, University of Minnesota Medical School, Duluth, MN 55812. E-mail: malabsi{at}umn.edu

Objective: Attenuated pain sensitivity and exaggerated adrenocortical stress reactivity have been documented in individuals at high risk for hypertension. The endogenous opioid system may play a role in these response alterations. We compared adrenocortical and nociceptive responses to opioid blockade using naltrexone in hypertension-prone men and women.

Methods: Ninety-nine participants completed two sessions during which a placebo or 50 mg naltrexone was administered using a double-blind, counterbalanced design. Participants rated their pain and completed the McGill Pain Questionnaire (MPQ) after three assessments of the nociceptive flexion reflex and after assessment of nociceptive pain threshold and tolerance. Saliva samples were obtained throughout the sessions.

Results: Salivary cortisol levels increased after pain assessment after the ingestion of naltrexone, but not after placebo, with the low-risk group exhibiting an earlier peak of cortisol response. Participants reported greater pain ratings and higher MPQ scores in the naltrexone versus placebo condition, and these effects were more pronounced in women. Pain threshold and tolerance were higher among high-risk men relative to low-risk men.

Conclusions: The results are consistent with the inhibitory effects of the endogenous opioids on cortisol response and suggest an altered response timeline among hypertension-prone individuals. The results demonstrate that hypoalgesia may be a marker of hypertension risk in men but not in women.

Key Words: cortisol • hypertension risk • pain • opioid blockade • naltrexone • gender

Abbreviations: ACTH = adrenocorticotropin; BP = blood pressure; CPT = cold pressor test; CRF = corticotrophin-releasing factor; HPA = hypothalamic-pituitary-adrenocortical axis; MPQ = McGill Pain Questionnaire; NFR = nociceptive flexion reflex; EMG = electromyographic activity.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Psychosomatic Society