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Updated: Jul 5, 2026

An Alternative to the Traditional Cold Pressor Test: The Cold Pressor Arm Wrap
Published on: January 16, 2014
Changes in central artery blood pressure and wave reflection during a cold pressor test in young adults
Darren P Casey1, Randy W Braith, Gary L Pierce
1Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA. casey.darren@mayo.edu
Abstract:
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) (P < 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, P < 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.
Related Concept Videos
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(two-step method)
Measurement of Blood Pressure
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Pre-Procedural Guidelines for Assessing Blood Pressure

