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Vascular reactivity in young adults and cardiovascular disease. A prospective study
Insights
Cardiovascular reactivity during the cold pressor test in young men does not predict future cardiovascular disease risk. This study found no association between blood pressure changes and later heart health outcomes.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Cardiovascular reactivity to the cold pressor test (CPT) has been linked to increased coronary heart disease (CHD) risk in middle-aged men.
- The predictive value of CPT-induced cardiovascular reactivity in young adulthood remains less understood.
Purpose of the Study:
- To investigate the association between systolic blood pressure reactivity during the CPT in young adulthood and the long-term risk of cardiovascular disease (CVD) and CHD.
- To determine if CPT response is an independent predictor of future cardiovascular events.
Main Methods:
- A prospective cohort study of 905 white male medical students (median age 22) from the Johns Hopkins Precursors Study.
- Baseline measurements included systolic blood pressure, CPT-induced systolic blood pressure change, smoking status, cholesterol levels, Quetelet index, and family history of CHD.
- Cardiovascular morbidity and mortality were tracked via annual questionnaires and death certificates.
Main Results:
- No significant association was found between systolic blood pressure change during the CPT (continuous or ≥20 mm Hg rise) and the risk of subsequent CVD or CHD.
- These findings remained consistent after adjusting for established cardiovascular disease risk factors.
- Previously reported associations might be confounded by subclinical arteriosclerosis present at baseline.
Conclusions:
- Cardiovascular reactivity to the CPT in young adulthood is not a strong predictor of future cardiovascular disease.
- The CPT may not be a useful screening tool for identifying young individuals at high risk for future heart disease.
- Further research may be needed to explore other potential early markers of cardiovascular risk.
Abstract:
Cardiovascular reactivity in response to the cold pressor test has been associated with an increased risk of coronary heart disease in middle-aged men. We studied 905 white male medical students, median age 22 years, in the Johns Hopkins Precursors Study. Systolic blood pressure, systolic blood pressure change during the cold pressor test, smoking, cholesterol, Quetelet index, and family history of coronary heart disease were measured on enrollment during 1948-1964. Incidence of cardiovascular morbidity and mortality was ascertained by annual questionnaires and death certificates. There was no association between change in systolic blood pressure during the cold pressor test, whether examined as a continuous variable or a 20 mm Hg or more rise, and the risk of subsequent cardiovascular disease or coronary heart disease. These findings did not change after adjustment for cardiovascular disease risk factors. Previously reported associations may have been due to preexisting arteriosclerosis, which increases the rise in systolic blood pressure during the cold pressor test. We conclude that cardiovascular reactivity to the cold pressor test in young adulthood is not a strong predictor of future cardiovascular disease.