Chronic pain (CP) has been associated with reduced baroreflex sensitivity (BRS) that may impact on both cardiovascular and pain regulatory processes. Hypertension (HTN) is also associated with reduced BRS, and research suggests CP is associated with increased HTN prevalence. Whether interrelationships between CP, BRS, and HTN risk reflect an underlying potentially heritable factor has not been studied. We therefore tested whether parental history of CP (PHCP) and HTN (PHHTN), which are associated with increased CP and HTN risk respectively, were associated with altered BRS. Simultaneous beat-to-beat blood pressure and electrocardiogram data were obtained during seated rest in 22 healthy controls and 17 CP subjects in two separate sessions. Mean spontaneous resting BRS in the time domain was derived from these measures using the sequence method (sequence up and down). PHCP+ subjects were marginally more likely to have CP themselves (p<.07). Across subject types, PHCP+ subjects had lower BRSup than PHCP- subjects (p<.001). General linear model analyses revealed significant Type X PHCP and Type X PHHTN interactions on BRSup (p's<.05). PHCP+ controls had moderately lower BRS than PHCP- controls; CP subjects with PHCP- status had exaggerated BRS relative to controls, whereas CP subjects with PHCP+ status had notably lower BRS values than any other group. PHHTN+ status was associated with decreased BRS in controls, but increased BRS in CP subjects. BRSdown analyses revealed a significant PHCP X PHHTN interaction (p<.05). This was due primarily to substantially higher BRS in subjects negative for both PHCP and PHHTN. Results suggest that PHCP+ status combined with presence of CP is particularly detrimental to baroreflex function, with possible implications for increased hypertension risk. Individuals with a negative parental history for both CP and HTN display more effective cardiovascular modulation, which may be associated with diminished hypertension risk.