Blood Pressure and Vascular Reactivity to the Cold Pressor Test

Barnett, Paul; Hines, Edgar A.; Schirger, Alexander; Gage, Robert P.

doi:10.1001/jama.1963.03700100071012

Cited by 53 publications

(22 citation statements)

References 7 publications

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“…A final consideration is the relative strength of the association between cold pressor reactivity and incidence of hypertension. Although having two parents with hypertension is a stronger prognostic factor in this cohort and other cohort studies, 6 the risk of hypertension associated with a 20 mm Hg increase in cold pressor systolic response is increased by over 90% and closely approximates the increased risk observed for a similar increase in basal systolic blood pressure.…”

Section: Discussionsupporting

confidence: 66%

“…Previous prospective studies have been limited by incomplete or short duration of follow-up or by the small size of the cohorts initially tested for reactivity to the cold pressor test. 6 - 17 -20 In all of these studies, the analyses were based on arbitrary definitions of reactivity introduced by Hines or Brown. None took into consideration the impact of time or age in the estimation of risk of development of hypertension, and few controlled for confounding factors.…”

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confidence: 99%

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Cardiovascular reactivity to the cold pressor test as a predictor of hypertension.

Menkes¹,

Matthews²,

Krantz³

et al. 1989

Hypertension

335

166

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Cardiovascular reactivity to stress is hypothesized to be a marker for subsequent neurogenic cardiovascular disease, but few prospective studies of this hypothesis are available. We studied 910 white male medical students who had their blood pressure and pulse rate measured before and during a cold pressor test in the years [1948][1949][1950][1951][1952][1953][1954][1955][1956][1957][1958][1959][1960][1961][1962][1963][1964]. Hypertensive status (requiring drug treatment) was ascertained by annual questionnaires in the 20-to 36-year follow-up period. An association was observed between maximum change in systolic blood pressure and later hypertension, with a cumulative incidence of hypertension by age 44 of 6.7%, 3.0%, and 2.4% for a change in systolic blood pressure in the upper, middle two, and lowest quartiles, respectively (Kaplan-Meier, p<0.02). After adjustment for study entry age, Quetelet Index, cigarette smoking, pretest systolic blood pressure, and paternal or maternal history of hypertension in a Cox model, the association persisted. The excess risk associated with systolic blood pressure reactivity was not apparent until the population aged some 20 years and was most apparent among those in whom hypertension developed before age 45 (relative risk=2.5, 95% confidence intervals=1.47, 4.71 for a 20 mm Hg change). Diastolic blood pressure and heart rate changes were not associated with later hypertension. These data suggest that persons prone to later hypertension manifest an altered physiology at a young age. (Hypertension 1989;14:524-530)

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Section: Discussionsupporting

confidence: 66%

mentioning

confidence: 99%

Cardiovascular reactivity to the cold pressor test as a predictor of hypertension.

Menkes¹,

Matthews²,

Krantz³

et al. 1989

Hypertension

335

166

View full text Add to dashboard Cite

show abstract

“…In 1961, 151 of the original subjects were again studied with use of a cold pressor test. 5 The Mayo Clinic records of the 151 subjects who had been given cold pressor tests in 1934 and 1961 were reviewed in 1979 without knowledge of the test responses. Casual blood pressure recordings made during routine office visits were abstracted from each patient's record.…”

Section: Methodsmentioning

confidence: 99%

Cold pressor test as a predictor of hypertension.

Wood¹,

Sheps²,

Elveback³

et al. 1984

Hypertension

359

181

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SUMMARY To determine the usefulness of the cold pressor test as a predictor of hypertension, we compared the blood pressure recordings available from 142 patients in 1979 with readings obtained during performance of two cold pressor tests, the first in 1934 when these subjects were children, and the second in 1961. Forty-eight subjects were hyperreactors to the tests in either 1934 or 1961, and 94 were normoreactors. At last follow-up, blood pressures in 14 of the hyperreactors were between 140 and 160 mm Hg systolic or 90 and 100 mm Hg diastolic (Stratum 1) and in 20 exceeded 160 mm Hg systolic or 100 mm Hg diastolic (Stratum 2). Ten normoreactors had casual blood pressures in Stratum 1 and eight in Stratum 2. Hypertension had thus occurred in 71% of the hyperreactors and 19% of the normoreactors. Fifteen hyperreactors were receiving antihypertensive therapy, and this reduced the severity of the casual blood pressure elevation in most patients to Stratum 1. Antihypertensive therapy had been started in three normoreactors. The duration of follow-up, 45 years, and the mean age at follow-up, almost 57 years, were greater in this study than in any previously reported study. Early hyperreactivity was related to future hypertension in enough subjects to suggest that an abnormal response to an external cold stimulus may be useful as an indicator of future hypertension. (Hypertension 6: 301-306, 1984) KEY WORDS • cold stimulus • blood pressure • hyperreactivity A LMOST 50 years ago, Hines and Brown 1 proposed that a period of vascular hyperreactivity preceded the development of sustained hypertension. They further suggested that vascular hyperreactivity manifested by an excessive pressor response to an external cold stimulus was a potential predictor of hypertension. Subsequent investigators have used the cold pressor test but have disagreed about its usefulness as a predictor of hypertension.2 " 1We report here the results of a 45-year follow-up study of 142 subjects who were originally studied by Hines, in an attempt to determine the value of the cold pressor test as an indicator of future hypertension. MethodsIn 1934, 300 Rochester, Minnesota, schoolchildren aged 7 to 17 years were studied by means of the cold pressor test. In 1961, 151 of the original subjects were again studied with use of a cold pressor test. 5 The Mayo Clinic records of the 151 subjects who had been given cold pressor tests in 1934 and 1961 were reviewed in 1979 without knowledge of the test responses. Casual blood pressure recordings made during routine office visits were abstracted from each patient's record. In most instances, more than two blood pressure readings were available for each patient during the last year of follow-up. In this circumstance an average blood pressure was determined.For the purposes of this study, a blood pressure level of less than 140/90 mm Hg is described as normotension. Higher pressures indicating hypertension were graded in the following manner: blood pressures of 140 to 159 mm Hg systolic or 90 to 99 mm Hg d...

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“…10 Many earlier investigators also reported a greater rise of blood pressure, both systolic and diastolic, during CPT, in patients of essential hypertension as compared to normotensive subjects. 11,12 Barnett and his associates, 13 restudied cold pressure test in 207 subjects after 27 yrs. They concluded that children of parents with hypertension are four times more likely to show increased vascular reactivity (Increased blood pressure) than the children of normotensive parents; which underlined the concept of inherited vascular reactivity.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Cold Pressor Test in Children of Hypertensive and Non Hypertensive Parents

Kumar¹,

Rathi²,

Agarwal³

et al. 2015

jemds

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BACKGROUND:Hypertension is a chronic condition of concern due to its role in the causation of coronary heart disease, stroke and vascular complications. Hypertension is a major risk factor for cerebrocardiovascular morbidity and mortality Therefore early identification of risk of hypertension would be important to its prevention. The cold pressor test, in which the response of blood pressure to the stimulus of external cold is measured, has been used to identify hyper reactor individuals who might develop hypertension. So the cold pressure test study examines its effectiveness as a predictor of hypertension. METHODS: Fifty healthy subjects (including males and females) from different MBBS batch in age group of 19-24 yrs were recruited and divided into two groups as study group_ with family history of hypertension (FH+) and control group_ without family history of hypertension (FH-). FH+ group had higher basal and supine systolic and diastolic blood pressor (SBP & DBP). RESULTS: During cold pressor test (CPT) the FH+ group showed higher rise of SBP and DBP. The hyper reactors (HR) and norm reactors (NR) were categorized by the criteria of a rise of more than 22 mmHg systolic and 18 mmHg diastolic blood pressure during CPT. The study suggests that identification of hyper reactors in population gives a better indication of potential hypertensive's that have positive family history of hypertension. KEYWORDS: Hypertension, Systolic Blood Pressure, Diastolic Blood Pressure, Cold Pressor Test INTRODUCTION:Hypertension is a chronic condition of concern due to its role in the causation of coronary heart disease, stroke and vascular complications. It is one of the major risk factor for cardiovascular mortality which accounts 20-50% of all deaths. Hypertension develops early in life as a result of encounters between stressful environmental factors and genetic predisposition. 1 Sympathetic over activity plays a significant role in development of neurogenic hypertension. 2 Hypertension has been reported to be generally associated with sympathetic overactivity. 3,4,5 The sympathetic response of certain individuals from both normotensive and hypertensive population have been reported to be more pronounced. 6 Again there is dilemma that who among the mild hypertensive eventually developed significant and essential hypertension. 7 There are also many other studies which have shown that hypertension is a major risk factor for cerebrocardiovascular morbidity and mortality Therefore early identification of risk of hypertension would be important to its prevention. The cold pressor test, in which the response of blood pressure to the stimulus of external cold is measured, has been used to identify hyper reactor individuals who might develop hypertension. So the cold pressure test study examines its effectiveness as a predictor of hypertension.

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Blood Pressure and Vascular Reactivity to the Cold Pressor Test

Cited by 53 publications

References 7 publications

Cardiovascular reactivity to the cold pressor test as a predictor of hypertension.

Cardiovascular reactivity to the cold pressor test as a predictor of hypertension.

Cold pressor test as a predictor of hypertension.

Comparison of Cold Pressor Test in Children of Hypertensive and Non Hypertensive Parents

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