Blood Pressure and Heart Rate Responses to Cold Pressor Test in Patients Admitted to Hospital due to Chest Pain

Cardiovascular hyperreactivity to stress may be a risk factor for future cardiovascular events. In this study we hypothesized increased cardiovascular responses to a cold pressor test (CPT) in coronary patients admitted to hospital due to chest pain compared with patients admitted with chest pain with suspected, but not later confirmed, coronary artery disease (CAD). A total of 20 patients were included in the study. All were admitted due to chest pain. None of the patients suffered from myocardial infarction. In 10 patients (CAD+) CAD was confirmed by positive exercise ECG or coronary angiography. In the other 10 patients (CAD-) all tests were negative. The two groups did not differ significantly in resting blood pressure, body mass index (BMI), age, gender or smoking status. A 1 min CPT was performed after 15 min supine rest. Blood pressure (BP) and heart rate (HR) responses were registered. There were significantly larger heart rate (p < 0.001) and systolic blood pressure (p < 0.01) responses to a cold pressure test in patients with chest pain and coronary heart disease than in patients with chest pain only. Percentage increases in HR and systolic BP also differed significantly. Cardiovascular responses to a cold pressor test were significantly larger in CAD patients admitted to hospital due to chest pain than in patients admitted with chest pain and suspected, but not later confirmed, CAD.