scholarly journals Altered Cardiovascular Reactivity to and Recovery from Cold Face Test-Induced Parasympathetic Stimulation in Essential Hypertension

2021 ◽  
Vol 10 (12) ◽  
pp. 2714
Author(s):  
Lisa-Marie Walther ◽  
Roland von Känel ◽  
Nadja Heimgartner ◽  
Claudia Zuccarella-Hackl ◽  
Ulrike Ehlert ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Chronic Stress ◽  
Cardiovascular Reactivity ◽  
Face Mask ◽  
Sympathetic Stimulation ◽  
Hypertension Status ◽  
Cold Face ◽  
Cold Face Test ◽  
Screening Scale

Essential hypertension is associated with increased sympathetic and diminished parasympathetic activity as well as impaired reactivity to sympathetic stimulation. However, reactivity and recovery from parasympathetic stimulation in hypertension are unknown. We investigated reactivity and recovery to primarily parasympathetic stimulation by Cold Face Test (CFT) in essential hypertension. Moreover, we tested whether chronic stress modulates CFT-reactivity dependent on hypertension status. The CFT was conducted by applying a cold face-mask for 2 min in 24 unmedicated, otherwise healthy hypertensive men and in 24 normotensive controls. Systolic and diastolic blood pressure (BP) and heart rate (HR) were measured repeatedly. Chronic stress was assessed with the Trier-Inventory-for-Chronic-Stress-Screening-Scale. Hypertensives did not exhibit diastolic BP decreases after CFT-cessation (p = 0.59) as did normotensives (p = 0.002) and failed to show HR decreases in immediate response to CFT (p = 0.62) when compared to normotensives (p < 0.001). Systolic BP reactivity and recovery patterns did not differ between hypertensives and normotensives (p = 0.44). Chronic stress moderated HR (p = 0.045) but not BP CFT-reactivity (p′s > 0.64) with chronically stressed normotensives showing similar HR reactivity as hypertensives. Our findings indicate impaired diastolic BP and HR reactivity to and recovery from CFT in hypertensives and a moderating effect of chronic stress on HR reactivity potentially reflecting reduced relaxation ability of the cardiovascular system.

scholarly journals Secrecy and the Pathogenesis of Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Randi Ettner ◽  
Frederic Ettner ◽  
Tonya White
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Cardiovascular Reactivity ◽  
Emotional Disclosure ◽  
Emotional Expressiveness ◽  
General Medical Practice ◽  
Gender Nonconforming ◽  
Medicine Physician ◽  
The Family ◽  
Regulation Of Blood Pressure

Literature supporting a relationship between emotions and regulation of blood pressure dates back to the early 1900s. Theoretical explanations of the pathophysiology of the correlation have centered on several possible trajectories, the most likely being cardiovascular reactivity to stress. Prospective studies have demonstrated that chronic stress and enduring traits such as defensiveness and anxiety, impacts the development of hypertension. An analysis of 195 genetic males seeking contrary hormones for treatment of gender dysphoria revealed a significantly increased prevalence of hypertension in this cohort. The authors attribute this increased prevalence to the known effects of emotional disclosure on health and conclude that the inhibition of emotional expressiveness is significant in the etiology and maintenance of essential hypertension in this population. As hypertension is associated with morbidity and mortality, the implications for the family medicine physician treating gender nonconforming individuals and other patients in the context of a general medical practice will be discussed.

Effects of age, sex, and physical fitness on responses to local cooling

1978 ◽  
Vol 44 (5) ◽  
pp. 813-817 ◽  
Author(s):  
J. LeBlanc ◽  
J. Cote ◽  
S. Dulac ◽  
F. Dulong-Turcot
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Physical Fitness ◽  
Female Group ◽  
Local Cooling ◽  
Trained Subjects ◽  
Cold Face ◽  
Hand Test ◽  
Older Subjects ◽  
Cold Face Test

The response to local cooling was estimated by the cold hand test (5 degrees C for 2 min) and the cold face test (0 degrees C with 66 km.h-1 wind for 2 min). Heart rate, blood pressure, and skin temperature were measured before, during, and after the tests. The increase in blood pressure (cold hand test) and the fall in Tsk (cold face test) were reduced in trained subjects. Similarly older subjects (53–60 yr of age) responded less to a cold hand test than younger subjects aged 20–40. However, the bradycardia caused by the cold face test was more pronounced in the older subjects. The responses to the cold hand and cold face tests were the same for male and female subjects. During the 2 min after the test, blood pressure and heart rate fell below initial values in the female group but not in the male. It is concluded that, besides adaptation to cold, individual factors such as age, sex, and physical fitness also have a relative importance in the responses to local cooling.

Reduced baroreflex sensitivity in elderly humans is not due to efferent autonomic dysfunction

1999 ◽  
Vol 98 (1) ◽  
pp. 103-110 ◽  
Author(s):  
D. O'MAHONY ◽  
C. BENNETT ◽  
A. GREEN ◽  
A. J. SINCLAIR
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Baroreflex Sensitivity ◽  
Reflex Response ◽  
Cognitive Stress ◽  
Age Related ◽  
Cold Face ◽  
Blood Pressure Responses ◽  
Age Range ◽  
Cold Face Test

A progressive decline in baroreflex sensitivity (BRS) is a characteristic feature of human aging, the basis of which is poorly understood. The purpose of the present study was to determine whether alterations in efferent baroreflex function might contribute to the age-related decrease in BRS. We studied 10 healthy young (mean age 30.5 years; age range 22–40 years; six male) and 10 healthy elderly (mean age 70.7 years; age range 67–75 years; five male) volunteers. We tested efferent cardiac vagal function using the bradycardiac response to the cold face test, and efferent sympathetic function using heart rate and blood pressure responses to four stress tests: (i) low-level cognitive stress, (ii) high-level cognitive stress, (iii) hand immersion in ice water (cold pressor test) and (iv) isometric sustained hand-grip. Haemodynamic responses to these stresses are mediated via efferent baroreflex pathways, whereas the afferent components of each reflex response are independent of afferent baroreflex pathways. BRS was measured from simultaneous Finapres-derived continuous blood pressure and digital ECG R–R interval data using the sequence analysis paradigm. As expected, BRS was significantly reduced in the elderly group (7.29±0.74 ms/mmHg; mean±S.E.M.) compared with the young group (13.84±1.13 ms/mmHg; P < 0.001). However, neither the bradycardiac responses to the cold face test nor the efferent sympathetically mediated heart rate/blood pressure responses to the stress test battery were significantly different between the young and elderly groups. We conclude that the age-related decrease in BRS is not attributable to impairments in the efferent sympathetic or parasympathetic system components of the baroreceptor reflex pathway.

Cold face test demonstrates parasympathetic cardiac dysfunction in familial dysautonomia

1999 ◽  
Vol 276 (6) ◽  
pp. R1833-R1839 ◽  
Author(s):  
M. J. Hilz ◽  
B. Stemper ◽  
P. Sauer ◽  
U. Haertl ◽  
W. Singer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Transfer Function ◽  
Power Spectra ◽  
Familial Dysautonomia ◽  
Cold Face ◽  
Parasympathetic Dysfunction ◽  
Transfer Function Gain ◽  
Cold Face Test

In familial dysautonomia (FD), i.e., Riley-Day syndrome, parasympathetic dysfunction has not been sufficiently evaluated. The cold face test is a noninvasive method of activating trigeminal brain stem cardiovagal and sympathetic pathways and can be performed in patients with limited cooperation. We performed cold face tests in 11 FD patients and 15 controls. For 60 s, cold compresses (0–1°C) were applied to the cheeks and forehead while we monitored heart rate, respiration, beat-to-beat radial artery blood pressure, and laser-Doppler skin blood flow at the first toe pulp. From these measurements heart rate variability parameters were calculated: root mean square of successive differences (RMSSD), coefficient of variation (CV), low- and high-frequency (LF and HF, respectively) power spectra of the electrocardiogram, and the LF transfer function gain between blood pressure and heart rate. All patients perceived cold stimulation and acknowledged discomfort. In controls, heart rate and skin blood flow decreased significantly during cold face test; in patients, both parameters decreased only briefly and not significantly. In controls, blood pressure, RMSSD, CV, and heart rate HF-power spectra increased but remained unchanged in patients. Respiration, as well as heart rate LF power spectra, did not change in either group. In controls, LF transfer function gain between blood pressure and heart rate indicated that bradycardia was not secondary to blood pressure increase. We conclude that the cold face test demonstrated that patients with FD have a reduced cardiac parasympathetic response, which implies efferent parasympathetic dysfunction.

Autonomic nervous system and adaptation to cold in man

1975 ◽  
Vol 39 (2) ◽  
pp. 181-186 ◽  
Author(s):  
J. LeBlanc ◽  
S. Dulac ◽  
J. Cote ◽  
B. Girard
Keyword(s):  
Blood Pressure ◽  
Pressor Response ◽  
Cold Pressor ◽  
Pressure Increase ◽  
Quebec City ◽  
Sympathetic Response ◽  
Blood Pressure Increase ◽  
Cold Face ◽  
Cold Face Test ◽  
Made In

The responses to cold hand test (blood pressure increase and tachycardia) and to a cold face test (blood pressure increase and bradycardia) were used to study the role of the autonomic nevrous system in cold adaptation in humans. The Eskimos (men, women, children) were shown to have a very weak sympathetic response to cold but the vagal response (bradycardia) was identical to that of white people. A group of mailmen from Quebec city living outdoors approximately 30 h/wk throughout the year was also studied. A significant decline in the cold pressor response and an enhanced bradycardia (cold face test) were observed at the end of the winter. Similarly the fall in skin temperature of the cheek was not as pronounced when the measurements were made in May compared to those made in October. A group of soldiers was also studied before and after an Arctic expedition. It was found that the bradycardia of the cold face test was also more pronounced after sojourning in the cold. These results indicate that repeated exposures to severe cold in men activate some adaptive mechanisms characterized by a diminution of the sympathetic response and a concomitant enhancement of the vagal activation normally observed when the extremities and the face are exposed to cold.

Telemedicine improves diagnosis of essential hypertension compared with usual care

2002 ◽  
Vol 8 (6) ◽  
pp. 344-349 ◽  
Author(s):  
Mary A M Rogers ◽  
Debra A Buchan ◽  
David Small ◽  
Christine M Stewart ◽  
Barbara E Krenzer
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Usual Care ◽  
Blood Pressure Monitoring ◽  
Controlled Trial ◽  
Care Group ◽  
Blood Pressure Monitor ◽  
Hypertension Status ◽  
Pressure Monitor ◽  
Telemedicine Service

A randomized controlled trial was conducted to assess the efficacy of a telemedicine service for the diagnosis of essential hypertension. The telemedicine service consisted of using an automatic home blood pressure monitor connected to an ordinary telephone line for the transmission of the data to a central computer. After use of the home monitor for a week, the results were converted to a report form and faxed to the patient's physician. The gold standard for assessment of true hypertension status was 24 h ambulatory blood pressure monitoring. A total of 74 patients from outpatient clinics were randomized into either the telemedicine service or usual care. Use of the telemedicine service significantly improved the detection of essential hypertension compared with usual care: in the telemedicine group, 64% of patients with essential hypertension were diagnosed; in the usual care group, 26% of patients with essential hypertension were diagnosed. Furthermore, diagnosis occurred earlier in the telemedicine group than in patients receiving usual care. Specificity and positive predictive value were similar in the two groups.

scholarly journals Stress-induced Aldosterone Hyper-Secretion in a Substantial Subset of Patients With Essential Hypertension

2015 ◽  
Vol 100 (8) ◽  
pp. 2857-2864 ◽  
Author(s):  
Athina Markou ◽  
Amalia Sertedaki ◽  
Gregory Kaltsas ◽  
Ioannis I. Androulakis ◽  
Chrisanthi Marakaki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Chronic Stress ◽  
Gene Mutations ◽  
Zona Glomerulosa ◽  
Control Group ◽  
Treadmill Test ◽  
Acth Stimulation ◽  
Number Of Patients ◽  
Aldosterone To Renin Ratio

Context: Aldosterone (ALD) secretion is regulated mainly by angiotensin II, K+, and adrenocorticotropic hormone (ACTH). Mineralocorticoid receptor antagonists (MRAs) have effectively been used for the treatment of patients with hypertension who do not have primary aldosteronism (PA). Objective: We tested whether chronic stress–related ACTH-mediated ALD hypersecretion and/or zona glomerulosa hypersensitivity could be implicated in the pathogenesis of essential hypertension (ESHT). Patients and Methods: One hundred thirteen hypertensives without PA and 61 normotensive controls underwent an ultralow-dose (0.03-μg) ACTH stimulation and a treadmill test. Patients with ALD hyper-response according to the cutoffs obtained from controls received treatment with MRAs and underwent genomic DNA testing for the presence of the CYP11B1/CYP11B2 chimeric gene and KCNJ5 gene mutations. A control group of 22 patients with simple ESHT received treatment with MRAs. Results: Based on the cutoffs of ALD and aldosterone-to-renin ratio (ARR) post-ACTH stimulation obtained from controls, 30 patients (27%) exhibited an ALD but not cortisol (F) hyper-response (HYPER group). This group had no difference in basal ACTH/renin (REN) concentrations compared with controls and the 83 patients with hypertension (73%) without an ALD hyper-response to ACTH stimulation. Patients in the HYPER group demonstrated significantly higher ALD concentrations, ARR, and ALD/ACTH ratio (AAR) in the treadmill test. Treatment with MRAs alone produced normalization of blood pressure in these patients whereas patients with hypertension with neither PA nor ALD hyper-response to ACTH stimulation who served as a control group failed to lower blood pressure. Also, two novel germline heterozygous KCNJ5 mutations were detected in the HYPER group. Conclusions: A number of patients with hypertension without PA show ACTH-dependent ALD hyper-secretion and benefit from treatment with MRAs. This could be related to chronic stress via ACTH hyper secretion and/or gene-mutations increasing the zona glomerulosa responsiveness to excitatory stimuli.

Sex Differences in Cardiovascular Reactivity

2009 ◽  
Vol 23 (2) ◽  
pp. 77-84 ◽  
Author(s):  
Matthew C. Whited ◽  
Kevin T. Larkin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sex Differences ◽  
Gender Roles ◽  
Cardiovascular Reactivity ◽  
Task Type ◽  
Conflict Task ◽  
Men And Women ◽  
Conflicting Evidence ◽  
Blood Pressure Responses

Sex differences in cardiovascular reactivity to stress are well documented, with some studies showing women having greater heart rate responses than men, and men having greater blood pressure responses than women, while other studies show conflicting evidence. Few studies have attended to the gender relevance of tasks employed in these studies. This study investigated cardiovascular reactivity to two interpersonal stressors consistent with different gender roles to determine whether response differences exist between men and women. A total of 26 men and 31 women were assigned to either a traditional male-oriented task that involved interpersonal conflict (Conflict Task) or a traditional female-oriented task that involved comforting another person (Comfort Task). Results demonstrated that women exhibited greater heart rate reactions than men independent of the task type, and that men did not display a higher reactivity than women on any measure. These findings indicate that sex of participant was more important than gender relevance of the task in eliciting sex differences in cardiovascular responding.

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