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Hemodynamic responses to the cold pressor test in individuals with metabolic syndrome: a case-control study in a multiracial sample of adults

Journal of Human Hypertension volume 38, pages 655–662 (2024)Cite this article

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Abstract

Previous research shows that exercise pressor and metaboreflex responses are significantly exaggerated in individuals with metabolic syndrome, but it is unclear if these exaggerated responses extend to the cold pressor test (CPT). This study tested the hypothesis that, contrary to previously reported exaggerated responses during exercise, CPT responses would not be significantly exaggerated in individuals with MetS compared to matched controls. Eleven individuals with MetS and eleven control participants matched by age, race, sex, and ethnicity completed a cardiometabolic prescreening and a CPT. Each CPT required participants to immerse their hand in ice water for two minutes while beat-by-beat blood pressure, heart rate (HR), and leg blood flow (LBF) were continuously measured. Leg vascular conductance (LVC) was calculated as LBF divided by mean arterial pressure (MAP). The precent changes in MAP, systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, LBF, and LVC were compared across time (BL vs. Minutes 1 and 2 of CPT) and between groups (MetS vs. Control) using repeated measures analyses of variance. As expected, MAP (f = 32.11, p < 0.001), SBP (f = 23.18, p < 0.001), DBP (f = 40.39, p < 0.001), and HR (f = 31.81, p < 0.001) increased during the CPT, and LBF (f = 4.75, p = 0.014) and LVC (f = 13.88, p < 0.001) decreased. However, no significant main effects of group or group by time interactions were observed (f ≤ 0.391, p ≥ 0.539). These findings indicate that the hemodynamic responses to the CPT are not significantly exaggerated in MetS, and therefore, previous reports of exaggerated exercise pressor and metaboreflex responses in MetS cannot be attributed to generalized sympathetic overexcitability.

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Fig. 1: Blood pressure and heart rate responses to the cold pressor test.
Fig. 2: Blood flow and vascular conductance responses to the cold pressor test.
Fig. 3: Results from two-one sided t-tests (TOST) employing three separate bounds of equivalence.

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Data availability

The raw data used in this study will be made available by authors upon reasonable request without undue delay and within the regulations of the University of Southern Mississippi.

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Acknowledgements

The authors would like to thank Kieron Cox, Diavion Stanfield, Alex Henderson, Havens L. Wise, Brandy Lowe, and Anne Speed for their technical support.

Funding

This study was supported by the Mississippi Center for Clinical and Translational Research, the National Institutes of Health, and the National Institute of General Medical Sciences (U54GM115428), as well as the University of Southern Mississippi (to J. Stavres and A.J. Graybeal).

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Authors and Affiliations

  1. School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, USA

    Jon Stavres, Anabelle Vallecillo-Bustos, Ta’Quoris A. Newsome, Ryan S. Aultman & Austin J. Graybeal

  2. Department of Kinesiology, Iowa State University, Ames, IA, USA

    Caleb F. Brandner

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Contributions

Conceived and designed research: JS and AJG; Performed experiments: JS, RA, TN, AVB, CFB, AJG; Analyzed data: JS, RA, TN, AVB, CFB, AJG; Interpreted results of experiments: JS, RA, TN, AVB, CFB, AJG; Prepared figures: JS; Drafted manuscript: JS; Edited and revised manuscript: JS, RA, TN, AVB, CFB, AJG; Approved final version of manuscript: JS, RA, TN, AVB, CFB, AJG.

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Correspondence to Jon Stavres.

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The protocols used in this study were approved by the University of Southern Mississippi internal review board (IRB# 22-1012) and all subjects provided written informed consent.

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Stavres, J., Vallecillo-Bustos, A., Newsome, T.A. et al. Hemodynamic responses to the cold pressor test in individuals with metabolic syndrome: a case-control study in a multiracial sample of adults. J Hum Hypertens 38, 655–662 (2024). https://doi.org/10.1038/s41371-024-00938-x

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