Why the study?
It remained unclear whether peripheral vasoconstriction is exaggerated during the cold pressor test in individuals defined as hyperreactors.
Is peripheral vasoconstriction exaggerated during the cold pressor test in individuals with hyperreactive blood pressure responses?
Is peripheral vasoconstriction exaggerated during the cold pressor test in individuals with hyperreactive blood pressure responses?
Hyperreactive blood pressure responses to the cold pressor test are not driven by increased peripheral vasoconstriction, and concurrent handgrip exercise attenuates the hyperreactive blood pressure response.
Hyperreactive BP responses to CPT may not involve exaggerated vasoconstriction; this Level 4 finding leaves mechanisms and clinical relevance open.
Background Individuals demonstrating increases in systolic systolic blood pressure or diastolic diastolic blood pressure blood pressure of at least 15 mmHg are considered hyperreactors to the cold pressor test (CPT). However, it remains unclear if peripheral vasoconstriction is similarly exaggerated during the CPT in these individuals. Methods Fifty-five individuals (54.5% non-White, 67.3% female) performed a single-visit study including a 2-min CPT of the foot, a 2-min bout of rhythmic handgrip exercise ([HG] 25% maximal voluntary contraction), and a 2-min combined trial (CPT + HG). Beat-by-beat heart rate (HR), blood pressure, and forearm blood flow (FBF) were continuously recorded, and vascular conductance (FVC) was calculated as FBF/mean arterial pressure (MAP). Results Hyperreactors ( n = 21) demonstrated exaggerated increases in blood pressure and rate pressure product during the CPT compared to normoreactors ( n = 34; all p < 0.001), while no significant differences were observed for ΔFBF ( f = 1.33, p = 0.259) or ΔFVC responses ( f = 2.10, p = 0.083). Results also indicated a blunted increase in ΔMAP during the CPT + HG trial compared to the CPT only trial in hyperreactors ( f = 6.95, p < 0.001), which was not observed in normoreactors ( f = 0.982, p = 0.420), and a blunted ΔFVC response during the CPT + HG trial in hyperreactors compared to normoreactors ( f = 2.57, p = 0.039). When analyzed separately, the blood pressure responses to HG exercise were also significantly exaggerated in hyperreactors compared to normoreactors (all p < 0.001), while ΔFBF and ΔFVC responses were not (both p ≥ 0.701). Conclusion These findings indicate that hyperreactive blood pressure responses to the CPT are not accompanied by increased peripheral vasoconstriction. Moreover, handgrip exercise attenuates hyperreactive blood pressure responses to the CPT.
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Stavres et al. (2025) studied this question.
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