Cold pressor test

The cold pressor test is a cardiovascular test performed by immersing the hand into an ice water container, usually for one minute, and measuring changes in blood pressure and heart rate. Its response is clinically indicative concerning vascular response and pulse excitability.

Other measures can also be obtained from the cold pressor such as pain threshold and pain tolerance.[1][2][3] This is done by requiring a participant to place their hand in the cold pressor for as long as they can. Once pain is present, they let the researcher know. Once the pain is unbearable, the participant removes his/her hand. This provides a measure of threshold (first feeling pain) and tolerance (total time minus threshold). This method is the most frequently used application of the cold pressor task. Comparable in terms of pain elicitation is the hot water immersion test, the equivalent to the cold pressor using hot water. The hot water immersion test (HIT) is equally capable of triggering a pain response without the confounding of baroreflex activation.[4]

Physiology

Sensory afferents trigger a systemic sympathetic activation leading to marked vasoconstriction. The result is an elevated pulse pressure(normal is 70mm Hg), due to catecholamine release. This increased pressure fills the ventricle to a greater extent, but stroke volume decreases for by an increase in afterload.

References

  • A. B. Lafleche et al. Arterial response during cold pressor test in borderline hypertension. Am J Physiol Heart Circ Physiol 275: H409-H415, 1998;
  1. ^ Daniel Lowery, Roger B. Fillingim, and Rex A. Wright, D; Fillingim, RB; Wright, RA (March/April 2003). "Sex Differences and Incentive Effects on Perceptual and Cardiovascular Responses to Cold Pressor Pain". Psychosomatic Medicine 65:284-291 (2003) 65 (2): 284–91. doi:10.1097/01.PSY.0000033127.11561.78. PMID 12651996. http://www.psychosomaticmedicine.org/cgi/content/full/65/2/284. Retrieved 2008-12-02. 
  2. ^ Staff (9-Apr-2003). "Higher pain tolerance in males can't be bought". Eurekalert. http://www.eurekalert.org/pub_releases/2003-04/cfta-hpt040903.php. Retrieved 2008-12-02. 
  3. ^ Jennifer L. Brown, David Sheffield, Mark R. Leary, and Michael E. Robinson (March/April 2003). "Social Support and Experimental Pain". Psychosomatic Medicine 65:276-283 (2003) 65 (2). http://www.psychosomaticmedicine.org/content/vol65/issue2/. Retrieved 2008-12-02. 
  4. ^ Anouk Streff, Linn K. Kuehl, Gilles Michaux, Fernand Anton (June 2009). "Differential physiological effects during tonic painful hand immersion tests using hot and ice water.". European Journal of Pain. doi:10.1016/j.ejpain.2009.05.011. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WF3-4WK3YPP-1&_user=1499307&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1137178618&_rerunOrigin=google&_acct=C000053220&_version=1&_urlVersion=0&_userid=1499307&md5=43dcba1642e2ca0c3242170fe90ea5c7. Retrieved 2008-12-02. 

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