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Updated: May 10, 2026

An Alternative to the Traditional Cold Pressor Test: The Cold Pressor Arm Wrap
Published on: January 16, 2014
Factors associated with blood pressure response to the cold pressor test: the GenSalt Study
Mingzhi Zhang1, Qi Zhao, Katherine T Mills
1Department of Epidemiology, Soochow University School of Public Health, Suzhou, China.
Background:
Blood pressure (BP) response to the cold pressor test (CPT) has been associated with increased risk of cardiovascular disease. We studied risk factors associated with BP response to CPT.
Methods:
We conducted the CPT among 2,682 individuals in rural north China. BP was measured using a standard mercury sphygmomanometer prior to and at 0, 1, 2, and 4 minutes after the participants immersed their right hand in ice water for 1 minute.
Results:
Sex, age, and baseline BP levels were significantly associated with BP response to the CPT. For example, maximum systolic BP response (mean ± SD) was greater in women than in men (15.5±10.7 vs. 13.8±10.0mm Hg; P < 0.0001), correspondingly higher with age (12.4±8.7, 13.8±10.0, and 16.4±11.2mm Hg for those aged < 35, 35-44, and ≥ 45 years, respectively; P for trend < 0.0001), and greater with higher BP (13.5±10.0, 14.9±10.2, and 17.4±11.5mm Hg for those with baseline BP < 120/80, 120-139/80-89, and ≥ 140/90mm Hg, respectively; P for trend < 0.0001). In multivariable analyses, we also observed that higher body mass index, physical inactivity, and alcohol consumption were significantly associated with greater BP response to the CPT.
Conclusions:
Our study indicates that females, older age, and elevated baseline BP levels are associated with greater BP response to the CPT. In addition, physical inactivity, higher weight, and alcohol consumption may also be related to BP hyperreactivity to stress.
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