Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults

Supaporn Kulthinee; Nitirut Nernpermpisooth; Montatip Poomvanicha; Jidapa Satiphop; Thizanamadee Chuang-Ngu; Napaporn Kaleeluan; Kittisak Thawnashom; Anuchit Manin; Rosarin Kongchan; Kingkarn Yinmaroeng; Peerapong Kitipawong; Phatiwat Chotimol

doi:10.1159/000517617

Cold Pressor Test Influences the Cardio-Ankle Vascular Index in Healthy Overweight Young Adults

Pulse (Basel). 2021 Aug 5;9(1-2):30-37. doi: 10.1159/000517617. eCollection 2021 Sep.

Affiliations

¹ Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.
² Department of Cardio-Thoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.
³ Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.
⁴ Cardiac Centre, Naresuan University Hospital, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.

Abstract

Objective: The cold pressor test (CPT) has been shown a potential sympathoexcitatory stimulus which increases aortic pulse wave velocity and the aortic augmentation index, suggesting that noninvasively, arterial stiffness parameters are altered by the CPT. The cardio-ankle vascular index (CAVI) is widely used for reflecting arterial stiffness, and the ankle-brachial index (ABI) for evaluating peripheral artery disease in obesity. We aimed to assess CAVI and ABI in overweight young adults in the context of sympathetic activation by using the CPT.

Methods: 160 participants were divided into 2 groups: 86 normal-weight (body mass index [BMI] 18.50-22.99 kg/m²) and 74 overweight (BMI ≥23 kg/m²). The CPT was performed by immersing a participant's left hand into cold water (3-5°C) for 3 min, and CAVI and ABI assessment.

Results: At baseline, the CAVI in the overweight group was significantly less than that in the normal-weight group (5.79 ± 0.85 vs. 6.10 ± 0.85; p < 0.05). The mean arterial pressure (MAP) for overweight was significantly greater than that for normal-weight subjects (93.89 ± 7.31 vs. 91.10 ± 6.72; p < 0.05). During the CPT, the CAVI increased in both normal-weight and overweight subjects, the CAVI value was greater during the CPT in overweight subjects by 14.36% (6.62 ± 0.95 vs. 5.79 ± 0.85, p < 0.05) and in normal-weight subjects by 8.03% (6.59 ± 1.20 vs. 6.10 ± 0.85, p < 0.05) than those baseline values. The CPT evoked an increase in systolic blood pressure (SBP), diastolic BP (DBP), heart rate (HR,) and pulse pressure (PP) in both groups. After a 4-min CPT period, the CAVI returned values similar to the baseline values in both groups, and the SBP, DBP, MAP, and PP in overweight participants were significantly higher than those in normal-weight participants. However, there was no significant difference in the ABI at baseline, during CPT, and post-CPT in either group.

Conclusions: Our results indicated that the CAVI was influenced by sympathetic activation response to the CPT in both normal-weight and overweight young adults. Specifically, during the CPT, the percentage change of the CAVI in overweight response was greater in normal-weight participants than baseline values in each group. The ABI was not found significantly associated with CPT. These findings suggesting that sympathoexcitatory stimulus by CPT influence CAVI results.

Keywords: Arterial stiffness; Atherosclerosis; Augmentation index; Pulse wave velocity.