Abstract P336: Blood Pressure Responses to Cold Pressor Test and Incidence of Hypertension: The GenSalt Study

The cold pressor test (CPT), which measures the response of blood pressure (BP) to the stimulus of external cold, has long been a standard test to characterize sympathetic nervous system activity and has been documented to predict cardiovascular risk. We conducted a CPT among 1,998 Han Chinese in 2003-05 and followed the study participants in 2008-09 and 2011-12 for incidence of hypertension. CPT was conducted after the participant had remained sitting for 20 minutes. The participant immersed his or her left hand in the ice water bath (3°C to 5°C) for 1 minute and BP measurements at 0, 60, 120, and 240 seconds were obtained after the left hand had been removed from the ice water bath. During the follow-up examinations, 3 BP measurements were obtained on each of 3 clinical visits. The maximum and area-under-curve (AUC) of systolic BP responses (mean ± SD) to CPT were 13.9±10.2 and 17.1±22.9 at the baseline examination. Over an average of 7.4 years of follow-up, we identified 490 incidence hypertension cases (systolic BP≥140 mmHg and/or diastolic BP ≥90 mmHg and/or use of antihypertensive medication). The age-adjusted cumulative incidences of hypertension by the quartiles of systolic BP responses to CPT were showed in the following table. These associations remained after adjustment for multiple covariates. Our study identified a strong and independent association between BP responses to CPT and subsequent incidence of hypertension. These data suggest that increased sympathetic nervous system activity may play a role in the development of hypertension.