Factors Associated With Blood Pressure Response to the Cold Pressor Test: The GenSalt Study

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.