Greater cardiovascular reactivity to a cold stimulus is due to higher cold pain perception in black Africans

Reimann, Manja; Hamer, Mark; Schlaich, Markus P.; Malan, Nicolaas T.; Ruediger, Heinz; Ziemssen, Tjalf; Malan, Leoné

doi:10.1097/hjh.0b013e328358faf7

Cited by 25 publications

(17 citation statements)

References 36 publications

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“…Identifying effective treatments and interventions for modifiable factors, such as chronic stress (eg, anxiety, depression), that modulate mechanisms associated with higher asleep BP among blacks compared with whites (eg, disturbances in autonomic function, altered sodium excretion) may help reduce racial differences in BP during sleep. 10–14 …”

Section: Discussionmentioning

confidence: 99%

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Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Booth

Anstey

Bello

et al. 2019

J of Clinical Hypertension

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Nocturnal hypertension and non-dipping blood pressure are each associated with increased risk of cardiovascular disease. We determined differences in nocturnal hypertension and non-dipping systolic/diastolic blood pressure among black and white men and women who underwent 24-hour ambulatory blood pressure monitoring at the Coronary Artery Risk Development in Young Adults study Year 30 Exam in 2015–2016. Asleep and awake periods were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as mean asleep systolic/diastolic blood pressure ≥ 120/70 mm Hg. Non-dipping systolic and diastolic blood pressure, separately, were defined as a decline in awake-to-asleep blood pressure < 10%. Among 767 participants, the prevalence of nocturnal hypertension was 18.4% and 44.4% in white and black women, respectively, and 36.4% and 59.9% in white and black men, respectively. After multivariable adjustment and compared with white women, the prevalence ratio (95% confidence interval) for nocturnal hypertension was 1.65 (1.18–2.32) for black women, 1.63 (1.14–2.33) for white men, and 2.01 (1.43–2.82) for black men. The prevalence of non-dipping systolic blood pressure was 21.5% and 41.0% in white and black women, respectively, and 20.2% and 37.9% in white and black men, respectively. Compared with white women, the multivariable-adjusted prevalence ratio (95% confidence interval) for non-dipping systolic blood pressure was 1.66 (1.18–2.32), 0.91 (0.58–1.42) and 1.66 (1.15–2.39) among black women, white men, and black men, respectively. Non-dipping diastolic blood pressure did not differ by race-sex groups following multivariable adjustment. In conclusion, black women and men have a high prevalence of nocturnal hypertension and non-dipping systolic blood pressure.

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Section: Discussionmentioning

confidence: 99%

“…7–14 A meta-analysis of 18 studies reported higher asleep BP and less BP dipping among blacks compared with whites. 15 However, the definition of asleep BP dipping was inconsistent across studies (eg, as the absolute or relative differences in awake and asleep BP levels).…”

Section: Introductionmentioning

confidence: 99%

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Booth

Anstey

Bello

et al. 2019

J of Clinical Hypertension

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“…The current results should be viewed in light of several limitations. First, the magnitude of the blood pressure response to cold stress is related to pain intensity, perception, and appraisal (Peckerman et al., ; Reimann et al., ). The current study has collected no information on pain.…”

Section: Discussionmentioning

confidence: 99%

Association of Type D personality with the autonomic and hemodynamic response to the cold pressor test

2013

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Mechanisms relating Type D personality to poor health are largely unknown, with autonomic nervous system function being a candidate. This study examined the physiologic response to cold stress. Undergraduates (N = 101, 84% female) underwent a cold pressor test. An electrocardiogram, impedance cardiogram, and blood pressure were recorded. Type D personality was assessed by self-report questionnaire. Type D was associated with increased systolic and diastolic blood pressure reactivity. Exploratory analyses showed Type D men to respond with increased respiratory sinus arrhythmia (i.e., higher parasympathetic activity), and decreased pre-ejection period (i.e., larger sympathetic activity), while Type D women showed a reciprocal response pattern. In conclusion, Type D personality was associated with an exaggerated hemodynamic response to cold stress, which may contribute to an increased risk of hypertension in Type D individuals.

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“…The role of the perception of pain during the CPT, however, must also not be underestimated as it could elevate blood glucose levels through the release of b-endorphins, stimulating hyperglycemia [11,24,25]. Reimann et al [11] reported that black Africans show a more pronounced CPT-induced increase in heart rate and blood pressure, which may be attributed to greater pain-related increments in blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Mixed a-adrenergic and b-adrenergic stimulation elicits a myocardial reaction through central mechanisms, whereas a-adrenergic stimulation elicits a vascular response pattern through vascular mechanisms [9,10]. The CPT also produces a pain stimulus, releasing b-endorphins which have a hyperglycemic effect [11]. The CPT elicits sympathetically mediated spontaneous vasoconstriction with subsequent increases in total peripheral resistance (TPR), cardiac afterload, and diastolic blood pressure (DBP) [12].…”

Section: Introductionmentioning

confidence: 99%

Acute cardiometabolic responses facilitating a state of chronic hyperglycemia and renal impairment

Joosten

Malan

Uys

et al. 2014

Cardiovascular Endocrinology

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Background Augmented a-adrenergic response patterns are associated with vascular risk in Africans. Therefore, the aims of this study were (a) to assess ethnic differences related to glucose and cardiovascular responses during acute laboratory stress, and (b) to assess whether these responses are associated with chronic hyperglycemia (HbA1c Z 5.7%) and albumin : creatinine ratio (ACR).Materials and methods Ambulatory blood pressure of 81 African and 100 Caucasian men was recorded. Beat-tobeat blood pressure was obtained during exposure to the Color Word Conflict (STROOP) and Cold Pressor Tests (CPT). Overnight 8 h fasting urine, basal and post-stress blood samples were collected for biochemical analyses.Results Augmented glucose responses (P < 0.001) were shown by the African men in response to the STROOP and CPT, in contrast to their Caucasian counterparts, who showed attenuated responses. In hyperglycemic African men, an enhanced a-adrenergic profile was revealed, with decreased stroke volume (P = 0.07) and cardiac output responses (P = 0.05). Augmented systolic blood pressure changes during the CPT predicted elevated ACR in African men [adjusted R 2 0.31: b, 0.54 (0.23, 0.85), P = 0.002]. In hyperglycemic Caucasian men, however, metabolic changes, that is augmented glucose changes to the STROOP test, predicted elevated ACR [adjusted R 2 0.19: b, 0.33 (0.02, 0.64), P = 0.04].Conclusion An a-adrenergic-driven cardiovascular response profile acted in tandem with augmented glucose responses in African men when exposed to acute laboratory stress. Pressure overload in Africans in contrast to metabolic responses in Caucasians may suggest different underlying mechanisms for ACR, a marker of renal impairment, when in a state of chronic hyperglycemia.

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Greater cardiovascular reactivity to a cold stimulus is due to higher cold pain perception in black Africans

Cited by 25 publications

References 36 publications

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Association of Type D personality with the autonomic and hemodynamic response to the cold pressor test

Acute cardiometabolic responses facilitating a state of chronic hyperglycemia and renal impairment

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