Evidence of Parasympathetic Activity of the Angiotensin Converting Enzyme Inhibitor, Captopril, in Normotensive Man

1985 ◽  
Vol 68 (1) ◽  
pp. 49-56 ◽  
Author(s):  
B. C. Campbell ◽  
Alessandra Sturani ◽  
J. L. Reid
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Enzyme Inhibitor ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pressure Change ◽  
Parasympathetic Activity ◽  
Valsalva Manoeuvre ◽  
The Difference ◽  
Normal Increase

1. Captopril (50 mg orally) produced a significant fall in systolic and diastolic blood pressure in six normotensive sodium replete subjects, without a rise in heart rate. 2. On captopril, there was no change in the expected normal increase in heart rate on standing. Supine plasma noradrenaline was not reduced by captopril and normal postural increases were maintained. 3. Atropine (0.04 mg/kg i.v.) reduced the difference in blood pressure change between captopril and placebo. 4. Facial immersion in water produced a bradycardia. This change was abolished by atropine and attenuated both by captopril and edrophonium (10 mg i.V.), a cholinesterase inhibitor. 5. Lying down after 6 min standing produced an immediate transient tachycardia, which was abolished by atropine and attenuated by captopril. 6. Blood pressure and heart rate rose after a cold pressor test on both captopril and placebo. 7. The tachycardia during the Valsalva manoeuvre was inhibited by edrophonium and to a lesser extent by captopril. The effects of captopril and edrophonium were additive. 8. Parasympathetic activity of captopril may contribute to its haemodynamic profile.

Pitfalls in the assessment of cardiovascular reflexes in patients with sympathetic failure but intact vagal control

1989 ◽  
Vol 76 (5) ◽  
pp. 523-528 ◽  
Author(s):  
J. J. van Lieshout ◽  
W. Wieling ◽  
K. H. Wesseling ◽  
J. M. Karemaker
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Time Course ◽  
Blood Pressure Response ◽  
Stress Test ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Valsalva Manoeuvre ◽  
Cardiovascular Reflexes ◽  
Vagal Control

1. Two patients are described who presented with orthostatic hypotension as the main symptom. The diagnosis was sympathetic failure with intact vagal control. 2. Unusual test result's were obtained. Assessment of the integrity of the total baroreflex arc by the Valsalva manoeuvre measuring only heart rate changes proved impossible, since the magnitude and time course of the heart rate response were normal notwithstanding the presence of a blood pressure response typical of sympathetic failure. 3. Sustained handgrip, cold pressor test and mental stress test all could induce a rise in blood pressure, despite the presence of sympathetic vasomotor lesions, but only when accompanied by a rise in heart rate. Efferent parasympathetic blockade by atropine, resulting in an increase in heart rate, was also accompanied by a substantial rise in blood pressure. These findings seem to result from a heart rate rise dependent increase in cardiac output unopposed by reflex vasodilatation. 4. In these patients the only baroreflex way to control blood pressure is by varying heart rate. This condition can be evaluated only if blood pressure and heart rate are measured on a beat-by-beat basis.

Defective Reflex Control of Heart Rate in Dialysis Patients: Evidence for an Afferent Autonomic Lesion

1982 ◽  
Vol 63 (3) ◽  
pp. 285-292 ◽  
Author(s):  
C. Zoccali ◽  
M. Ciccarelli ◽  
Q. Maggiore
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Autonomic Function ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Valsalva Manoeuvre ◽  
Dialysis Patients ◽  
Pressor Test ◽  
Reflex Control ◽  
Deep Breathing Test

1. To localize the site of autonomic abnormality in patients undergoing haemodialysis, tests of overall autonomic function based on either changes in blood pressure (posture, sustained handgrip) or heart rate (Valsalva manoeuvre, 30:15 ratio, deep breathing test) were used. Integrity of the sympathetic efferent arc was examined by using the cold pressor test and the parasympathetic efferent arc by the atropine test. Eighteen patients and 12 control subjects were studied. 2. Changes in blood pressure on standing, sustained handgrip and in the cold pressor test were the same in the two groups. 3. In contrast, 11 patients had abnormal results in at least two of the three heart-rate-based tests. 4. Three of the 11 dialysis patients with evidence of autonomic involvement showed abnormal responses to atropine, indicating an efferent parasympathetic lesion, whereas the majority had a normal response to the atropine test, suggesting an afferent lesion only. 5. Evidence of autonomic involvement was not associated with hypertension nor confined to patients with dialysis hypotension.

Variability of the haemodynamic responses to laboratory tests employed in assessment of neural cardiovascular regulation in man

1985 ◽  
Vol 69 (5) ◽  
pp. 533-540 ◽  
Author(s):  
Gianfranco Parati ◽  
Guido Pomidossi ◽  
Agustin Ramirez ◽  
Bruno Cesana ◽  
Giuseppe Mancia
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Test Performance ◽  
Blood Pressure Response ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Cardiovascular Regulation ◽  
Pressor Test ◽  
Carotid Baroreceptor ◽  
Baroreceptor Stimulation

1. In man evaluation of neural cardiovascular regulation makes use of a variety of tests which address the excitatory and reflex inhibitory neural influences that control circulation. Because interpretation of these tests is largely based on the magnitude of the elicited haemodynamic responses, their reproducibility in any given subject is critical. 2. In 39 subjects with continuous blood pressure (intra-arterial catheter) and heart rate monitoring we measured (i) the blood pressure and heart rate rises during hand-grip and cold-pressor test, (ii) the heart rate changes occurring during baroreceptor stimulation and deactivation by injection of phenylephrine and trinitroglycerine, and (iii) the heart rate and blood pressure changes occurring with alteration in carotid baroreceptor activity by a neck chamber. Each test was carefully standardized and performed at 30 min intervals for a total of six times in each subject. 3. The results showed that the responses to any test were clearly different from one another and that this occurred in all subjects studied. For the group as a whole the average response variability (coefficient of variation) ranged from 10.2% for the blood pressure response to carotid baroreceptor stimulation to 44.2% for the heart rate response to cold-pressor test. The variability of the responses was not related to basal blood pressure or heart rate, nor to the temporal sequence of the test performance. 4. Thus tests employed for studying neural cardiovascular control in man produce responses whose reproducibility is limited. This phenomenon may make it more difficult to define the response magnitude typical of each subject, as well as its comparison in different conditions and diseases.

Effects of the cold pressor test on short-term fluctuations of finger arterial blood pressure and heart rate in normal subjects

1993 ◽  
Vol 3 (5) ◽  
pp. 303-310 ◽  
Author(s):  
Frank Weise ◽  
Dominique Laude ◽  
Arlette Girard ◽  
Philippe Zitoun ◽  
Jean-Philippe Siché ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Pressure ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Normal Subjects ◽  
Short Term ◽  
Pressor Test ◽  
Arterial Blood

scholarly journals Acute Cardiovascular Effects of Epidural Spinal Cord Stimulation

2007 ◽  
Vol 5;10 (9;5) ◽  
pp. 677-685
Author(s):  
David M. Schultz
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Spinal Cord Stimulation ◽  
Statistical Significance ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Arterial Blood

Background: Several animal studies support the contention that thoracic spinal cord stimulation (SCS) might decrease arterial blood pressure. Objective: To determine if electrical stimulation of the dorsal spinal cord in humans will lower mean arterial pressure (MAP) and heart rate (HR). Design: Case Series Methods: Ten normotensive subjects that were clinically indicated for SCS testing were studied. Two of the 10 patients who underwent testing were excluded from the analysis because they did not respond to the Cold Pressor Test (CPT). Systolic blood pressure, diastolic blood pressure, and heart rate were measured continuously at the wrist (using the Vasotrac device). SCS was administered with quadripolar leads implanted into the epidural space under fluoroscopic guidance. SCS was randomly performed either in the T1-T2 or T5-T6 region of the spinal cord during normal conditions as well as during transient stress induced by CPT. The CPT was conducted by immersing the non-dominant hand in ice-cold water for 2 minutes. Results: There were moderate decreases in MAP and HR during SCS at the T5-T6 region compared to baseline that did not reach statistical significance. However, SCS at the T1-T2 region tended to increase MAP and HR compared to baseline but the change did not reach statistical significance. Arterial blood pressure was transiently elevated by 9.4 ± 3.8 mmHg using CPT during the control period with SCS turned off and also during SCS at either the T1-T2 region or T5-T6 region of the spinal cord (by 9.2 ± 5 mmHg and 10.7 ± 8.4 mmHg, respectively). During SCS at T5-T6, the CPT significantly increased MAP by 5.9±7.1 mmHg compared to control CPT (SCS off). Conclusion: This study demonstrated that SCS at either the T1-T2 or T5-T6 region did not significantly alter MAP or HR compared to baseline (no SCS). However, during transcient stress (elevated sympathetic tone) induced by CPT, there was a significant increase in MAP and moderate decrease in HR during SCS at T5-T6 region, which is not consistent with previous data in the literature. Acute SCS did not result in adverse cardiovascular responses and proved to be safe. Key words: Spinal cord stimulation, mean arterial pressure, heart rate, cold pressor test

scholarly journals Pain catastrophizing in athletes correlates with pain and cardiovascular changes during a painful cold pressor test

10.4085/16-20 ◽  
2020 ◽  
Author(s):  
Lentini Matylda ◽  
Scalia Joseph ◽  
Berger Lebel Frédérike ◽  
Touma Fadi ◽  
Jhajj Aneet ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Response ◽  
Pain Catastrophizing ◽  
Cold Pressor Test ◽  
Objective Measure ◽  
Cold Pressor ◽  
Pressor Test ◽  
Cardiovascular Variables

Abstract Context: Athletes are often exposed to pain due to injury and competition. There is preliminary evidence that cardiovascular measures could be an objective measure of pain, but the cardiovascular response can be influenced by psychological factors such as catastrophizing. Objectives: The purpose of our study was to use a painful cold pressor test to measure the relationship between catastrophizing, pain, and cardiovascular variables in athletes. Design: Pre-post test. Setting: We completed all measures in a laboratory setting. Participants: Thirty-six male rugby athletes participated in the study. Main outcome measures: We measured catastrophizing with the Pain Catastrophizing Scale and pain with a Numeric Pain Rating Scale. Cardiovascular measures included heart rate, systolic, and diastolic blood pressure, and heart rate variability. Results: During the cold pressor test, participants experienced a significant increase in pain (0 to 4.1±2.2), systolic blood pressure (126.7±16.5mm Hg to 149.7±23.4mm Hg), diastolic blood pressure (76.9±8.3mm Hg to 91.9±11.5mm Hg) and heart rate variability (from 0.0164ms±0.0121 to 0.0400ms±0.0323) (all p<.001). In addition, there was a significant decrease in heart rate after the cold pressor test (p=0.04). There was a significant correlation between athlete's pain catastrophizing to both pain intensity and change in heart rate during the cold pressor test (p=.017 and p=.003 respectively). A significant linear regression indicated pain and catastrophizing explained 29% of the variance of the change in heart rate (p=.003). Conclusion: Athletes who have catastrophizing thoughts are more likely to experience higher levels of pain and a greater cardiovascular response during a painful stimulus. The change in cardiovascular variables may be a good alternative for an objective measure of pain in athletes in the future.

scholarly journals Effect of Adrenomedullin on Cardiovascular Response to Sympathetic Autonomic Stress in Normotensive and Hypertensive Nigerians

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Simiat Olanike Elias ◽  
Irene Yewande Bamgbade
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Response ◽  
Statistical Significance ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
The Body ◽  
Pressor Test ◽  
Before And After ◽  
The Difference ◽  
Insignificant Correlation

Adrenomedullin is a potent vasodilator with established cardio-protective potentials when the body is exposed to stress. Sympathetic autonomic stress can lead to systolic (SBP) and diastolic blood pressure (DBP) reactivity which is a predictor of stroke. This study was to determine the effect of Adrenomedullin on cardiovascular response to sympathetic autonomic stress using the Cold Pressor Test in normotensive (NT) and hypertensive (HT) adults. Cardiovascular response to the CPT was measured among 30 NT and 30 HT participants, via blood pressure and heart rate before and after exposure to the cold pressor test (CPT). Plasma Adrenomedullin (ADM) was also determined by means of ELISA. Data were expressed as mean±S.E.M and statistical significance was accepted at 95% confidence interval. Exposure to CPT led to significant increases in SBP and DBP in both NT and HT participants with greater effect in HT (p<0.0001). Plasma Adrenomedullin was significantly higher among the NT but the difference on effect of response to CPT in both groups of participants was not significant. There was a negative and insignificant correlation between the ADM level and change in SBP and DBP among the NT participants but a positive and insignificant correlation with both SBP and DBP among the HT participants. We conclude that plasma Adrenomedullin may prevent the development of hypertension in black individuals.

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