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Published on: January 16, 2014
Cold Pressor Test in Primary Hypertension: A Cross-Sectional Study
1Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Insights
Patients with primary hypertension showing a positive cold pressor test (CPT) have poorer blood pressure control and increased heart failure risk, often linked to high-salt diets. Diuretic use improves BP control in these individuals.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Investigation
Background:
- Primary hypertension is a significant global health concern.
- The cold pressor test (CPT) is a physiological stressor used to evaluate cardiovascular responses.
- Understanding patient characteristics associated with positive CPT responses is crucial for risk stratification.
Purpose of the Study:
- To characterize patients with primary hypertension exhibiting a positive response to the cold pressor test (CPT).
- To identify clinical factors and outcomes associated with positive CPT results in hypertensive patients.
Main Methods:
- A cross-sectional study involving 48 hospitals from November 2018 to November 2019.
- Cold pressor test (CPT) performed on patients with primary hypertension.
- Demographic data, complications, and 12-month follow-up for mortality, myocardial infarction, stroke, and heart failure hospitalization were collected.
Main Results:
- 30.7% of patients had a positive CPT.
- Positive CPT group showed lower blood pressure control, higher prevalence of high-salt diet, diabetes, hyperuricemia, left ventricular hypertrophy, carotid plaques, coronary heart disease, and heart failure.
- A high-salt diet was correlated with positive CPT (OR=1.228).
- Diuretic use improved blood pressure control in the positive CPT group (54.6% vs 42.6%).
- Heart failure incidence was higher in the positive CPT group (7.35% vs 5.01%) after 12 months.
Conclusions:
- Positive CPT responders in primary hypertension exhibit poorer blood pressure control and elevated heart failure risk.
- High-salt diet preference may contribute to positive CPT responses.
- Diuretics are effective in improving blood pressure control for patients with positive CPT responses.
Objectives:
To investigate the characteristics of patients with primary hypertension who had positive responses to the cold pressor test (CPT).
Methods:
This cross-sectional study was conducted between November 2018 to November 2019, and the CPT was performed in patients with primary hypertension in 48 hospitals. The demographic characteristics and complications were collected through a questionnaire and physical examinations. A 12-month follow-up was conducted to identify the occurrence of the following events: a) all-cause mortality; b) myocardial infarction; c) stroke; d) hospitalized for heart failure.
Results:
The CPT was positive in 30.7% of the patients. Compared with the negative CPT group, the positive CPT group was associated with a lower rate of blood pressure control, and was more likely to have a high salt diet, diabetes, hyperuricemia, left ventricular wall thickening, carotid plaques, coronary heart disease and heart failure. A high-salt diet (OR = 1.228, 95%CI: 1.037-1.456) was found to be correlated with the positive result of CPT. Among patients in the positive CPT group, those using diuretics had a significantly higher rate of blood pressure control than those not using diuretics (54.6 vs.42.6%, x2 = 6.756, P = 0.009). After a 12-month follow-up, the incidence of heart failure in the positive CPT group was significantly higher than that in the negative CPT group (7.35 vs.5.01%, x2 = 3.945, P = 0.047).
Conclusions:
Patients with positive responses to the CPT had lower rates of BP control and a high risk of heart failure, which may be related to their preference for a high-salt diet. The use of diuretics helps to better control blood pressure in those patients.
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