Hypertension is associated with knee osteoarthritis pain in an age-dependent manner.

Females with hypertension had significantly greater odds of late-stage radiographic knee OA compared to normotensive females.

• Late-stage radiographic knee OA was defined as Kellgren-Lawrence grade > 2 (KL 3-4).
• Adjusted odds ratio for females with hypertension vs. normotensive females was AOR = 3.70 (95% CI = 1.63–8.37; p = 0.002).
• This association was not observed in males.
• Cross-sectional analysis included 253 adults aged 45–85 years with or without knee pain.

Hypertension was associated with an age-dependent decline in WOMAC total pain scores.

• The interaction between hypertension and age predicted WOMAC total scores with β = -1.018, p < 0.001.
• No such age-dependent change in WOMAC scores was observed in normotensive individuals.
• WOMAC (Western Ontario and McMaster Universities Arthritis Index) was used to assess self-reported knee pain outcomes.

Hypertension was associated with an age-dependent decline in movement-evoked pain following physical performance tasks.

• Movement-evoked pain was assessed following the Short Physical Performance Battery (SPPB).
• The hypertension-by-age interaction for balance-evoked pain: β = -0.881, p = 0.001.
• The hypertension-by-age interaction for walking-evoked pain: β = -1.017, p = 0.001.
• No age-dependent change in movement-evoked pain was observed in normotensive individuals.

Hypertensive individuals had greater odds of poor physical performance compared to normotensive individuals.

• Adjusted odds ratio for poor physical performance in hypertensive vs. normotensive individuals: AOR = 1.96 (95% CI: 1.08–3.70; p = 0.029).
• Physical performance was assessed using the Short Physical Performance Battery (SPPB).
• This finding occurred in the context of hypertensive individuals reporting less knee pain with increasing age, suggesting a dissociation between pain report and physical function.

The study was designed to examine whether hypertension influences OA pain outcomes in an age-dependent manner among middle-aged and older adults.

• Cross-sectional analysis of 253 adults aged 45–85 years with or without knee pain was performed.
• Hypertension was defined by self-reported diagnosis or use of antihypertensive medications.
• Radiographic knee OA was assessed using Kellgren-Lawrence grades, categorized as none/early-stage (KL 0–2) or late-stage (KL 3–4).
• The study hypothesized that hypertension would influence pain outcomes in an age-dependent manner and associate with greater radiographic OA severity.

The findings suggest that hypertensive individuals may deviate from a progressive OA pain trajectory, contributing to discordance between joint damage and pain.

• Despite having more severe radiographic OA (in females) and poorer physical performance, hypertensive individuals reported less knee pain with increasing age.
• The authors propose that hypertension-related mechanisms may contribute to the well-documented discordance between structural joint damage and pain in OA.
• These results highlight the potential role of cardiovascular comorbidities in modifying pain perception in OA, particularly in an age-dependent fashion.