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Changes in central artery blood pressure and wave reflection during a cold pressor test in young adults


The relative contribution of sympathetic nervous system (SNS)-induced increase in peripheral vascular resistance on central artery blood pressure (BP) and aortic wave reflection (augmentation index; AIx) is not completely understood. Central BP and wave reflection characteristics were measured using radial artery applanation tonometry before, during a 3-min cold pressor test (CPT), and 90 and 180-s post-CPT in 15 young, healthy adults (25 ± 1 years). The CPT resulted in a greater magnitude of change in the estimated aortic systolic (31 vs. 23%, P < 0.05) and pulse (31 vs. 13%, P < 0.05) BP compared with the change in brachial artery BP. Additionally, the CPT resulted in an increased mean arterial pressure (MAP) (< 0.05) and AIx (10 ± 2 vs. 26 ± 2%, P < 0.05). The change in MAP during the CPT was correlated to the change in AIx (r = 0.73, P < 0.01) and inversely related to roundtrip duration of the reflected wave to the periphery and back (r = –0.57, < 0.05). The present study suggests that cold pressor testing results in a significant increase in arterial wave reflection intensity, possibly due to an increased MAP. However, the greater increase in systolic and pulse BP in the central compared with the peripheral circulation suggests that increased central artery wave reflection intensity contributes to increased left ventricular myocardial oxygen demand during CPT-induced hypertension.

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  • Casey DP, Pierce GL, Nichols WW, Braith RW (2006) Measurement of pulse wave velocity and augmentation index is reproducible in young, healthy men (abstract). Med Sci Sport Exer 38:S185–S186

    Google Scholar 

  • Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, Kass DA (1997) Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure: validation of generalized transfer function. Circulation 95:1827–1836

    PubMed  CAS  Google Scholar 

  • Dinenno FA, Tanaka H, Stauffer BL, Seals DR (2001) Reductions in basal limb blood flow and vascular conductance with human ageing: role for augmented alpha-adrenergic vasoconstriction. J Physiol 536:977–983

    PubMed  Article  CAS  Google Scholar 

  • Dishman RK, Nakamura Y, Jackson EM, Ray CA (2003) Blood pressure and muscle sympathetic nerve activity during cold pressor stress: fitness and gender. Psychophysiology 40:370–380

    PubMed  Article  Google Scholar 

  • Edwards DG, Gauthier AL, Hayman MA, Lang JT, Kenefick RW (2006) Acute effects of cold exposure on central aortic wave reflection. J Appl Physiol 100:1210–1214

    PubMed  Article  Google Scholar 

  • Esler M (2000) The sympathetic system and hypertension. Am J Hypertens 13:99S–105S

    PubMed  Article  CAS  Google Scholar 

  • Gallagher D, Adji A, O’Rourke MF (2004) Validation of the transfer function technique for generating central from peripheral upper limb pressure waveform. Am J Hypertens 17:1059–1067

    PubMed  Article  Google Scholar 

  • Geleris P, Stavrati A, Boudoulas H (2004) Effect of cold, isometric exercise, and combination of both on aortic pulse in healthy subjects. Am J Cardiol 93:265–267

    PubMed  Article  Google Scholar 

  • Koch DW, Leuenberger UA, Proctor DN (2003) Augmented leg vasoconstriction in dynamically exercising older men during acute sympathetic stimulation. J Physiol 551:337–344

    PubMed  Article  CAS  Google Scholar 

  • Lambert EA, Schlaich MP (2004) Reduced sympathoneural responses to the cold pressor test in individuals with essential hypertension and in those genetically predisposed to hypertension: no support for the “pressor reactor” hypothesis of hypertension development. Am J Hypertens 17:863–868

    PubMed  Google Scholar 

  • Laurent S, Hayoz D, Trazzi S, Boutouyrie P, Waeber B, Omboni S, Brunner HR, Mancia G, Safar M (1993) Isobaric compliance of the radial artery is increased in patients with essential hypertension. J Hypertens 11:89–98

    PubMed  Article  CAS  Google Scholar 

  • Murgo JP, Westerhof N, Giolma JP, Altobelli SA (1980) Aortic input impedance in normal man: relationship to pressure wave forms. Circulation 62:105–116

    PubMed  CAS  Google Scholar 

  • Nichols WW (2005) Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens 18:3S–10S

    PubMed  Article  Google Scholar 

  • Nichols WW, O’Rourke MF (2005) McDonald’s blood flow in arteries: theoretical, experimental and clinical principles, 5th edn. Hodder Arnold Publishing, London

    Google Scholar 

  • Nichols WW, Singh BM (2002) Augmentation index as a measure of peripheral vascular disease state. Curr Opin Cardiol 17:543–551

    PubMed  Article  Google Scholar 

  • Pascualy M, Petrie EC, Brodkin K, Peskind ER, Veith RC, Raskind MA (1999) Effects of advanced aging on plasma catecholamine responses to the cold pressor test. Neurobiol Aging 20:637–642

    PubMed  Article  CAS  Google Scholar 

  • Pauca AL, O’Rourke MF, Kon ND (2001) Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 38:932–937

    PubMed  Article  CAS  Google Scholar 

  • Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, Umans JG, Howard BV (2007) Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the strong heart study. Hypertension 50:197–203

    PubMed  Article  CAS  Google Scholar 

  • Schobel HP, Heusser K, Schmieder RE, Veelken R, Fischer T, Luft FC (1998) Evidence against elevated sympathetic vasoconstrictor activity in borderline hypertension. J Am Soc Nephrol 9:1581–1587

    PubMed  CAS  Google Scholar 

  • Victor RG, Leimbach WN Jr, Seals DR, Wallin BG, Mark AL (1987) Effects of the cold pressor test on muscle sympathetic nerve activity in humans. Hypertension 9:429–436

    PubMed  CAS  Google Scholar 

  • Wilkinson IB, Fuchs SA, Jansen IM, Spratt JC, Murray GD, Cockcroft JR, Webb DJ (1998) Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis. J Hypertens 16:2079–2084

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Darren P. Casey.

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Casey, D.P., Braith, R.W. & Pierce, G.L. Changes in central artery blood pressure and wave reflection during a cold pressor test in young adults. Eur J Appl Physiol 103, 539–543 (2008).

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  • Wave reflection
  • Blood pressure
  • Sympathetic nervous system