The Value of the Cold Pressor Test in the Prediction of Hypertension and Toxæmia in Pregnancy

Krieger, Vera I.; Weiden, Sara

doi:10.5694/j.1326-5377.1947.tb63669.x

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…'0 11 Up to the present, exact knowledge of the nature and significance of the cold pressor response has been limited by the intermittent measurements possible with the sphygmomanometer. However, now that continuous direct recording of arterial pressure is established as an accurate and reliable laboratory procedure, a new tool is available for the study of the cold pressor test.…”

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confidence: 99%

The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

et al. 1955

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The response of the intra-arterial pressure to the cold immersion stimulus was studied in 42 healthy young adults, continuous direct (arterial-pressure) recording being used. The average systolic elevation was 22.6 mm. Hg and the average diastolic elevation was 16.3 mm. Hg. The difference between direct and indirect methods of measuring blood pressure was studied in 351 simultaneous determinations in 35 of these young adults. The direct systolic pressure averaged 9.7 mm. Hg higher and the diastolic pressure was 7.3 mm. Hg lower than the indirect measurement.T HE cold pressor test of Hines and Brown1 has been used widely during the past 22 years in the study of essential hypertension2-9 and the toxemias of pregnancy.'0 11 Up to the present, exact knowledge of the nature and significance of the cold pressor response has been limited by the intermittent measurements possible with the sphygmomanometer. However, now that continuous direct recording of arterial pressure is established as an accurate and reliable laboratory procedure, a new tool is available for the study of the cold pressor test.The response of the intra-arterial pressure to the cold immersion stimulus (4 C. for 60 seconds) was studied in 42 healthy young adults, continuous direct arterial pressure recording being used. The cold pressor test of Hines and Brown was applied repeatedly at short intervals, and the direct record was examined with regard to (1) maximal elevation of pressure, (2) time required to reach the maximal pressure and (3) time needed to return to one half the maximal pressure (the last figure was taken as a measure of the recovery time). The difference between the direct and

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confidence: 99%

The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

et al. 1955

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“…After screening of title and abstracts, we excluded 27 558 articles that concerned other topics. This left 1112 articles for full‐text evaluation, 17 of which could not be retrieved despite attempts to obtain them from other libraries in the Netherlands or by contacting the authors via Research Gate 17–33 . Of the 1095 manuscripts with full text available, 981 were excluded.…”

Section: Resultsmentioning

confidence: 99%

Cardiac output and peripheral vascular resistance during normotensive and hypertensive pregnancy – a systematic review and meta‐analysis

Mulder

Haas

Mohseni

et al. 2021

BJOG

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Background In‐depth insight into haemodynamic changes during normotensive pregnancy may help identify women at risk for gestational hypertensive complications. Objectives To determine the magnitude of changes in cardiac output and its determinants stroke volume and heart rate, and total peripheral vascular resistance during singleton normotensive and hypertensive pregnancies. Search strategy PubMed (NCBI) and Embase (Ovid) databases were searched from their inception up to November 2019. Selection criteria Studies reporting original measurements of haemodynamic parameters during pregnancy together with a non‐pregnant reference measurement. Studies including women using antihypertensive medication were excluded. Data collection and analysis Pooled mean differences between pregnant and non‐pregnant women, and absolute values of haemodynamic parameters were calculated for predefined gestational intervals using a random‐effects model in normotensive and hypertensive pregnancy. Meta‐regression analysis was used to analyse group differences in adjustments and absolute values during pregnancy. Main results In normotensive pregnancies, cardiac output increased from the first weeks on, reaching its highest level early in the third trimester (mean difference, 1.41 l·min1; 95% CI 1.18–1.63 l·min). In parallel, vascular resistance decreased progressively until its nadir in the early third trimester (mean difference, −331 dyn·sec–1·cm–5; 95% CI −384 to −277 dyn·sec–1·cm–5) and then increased slightly at term. In hypertensive pregnancies, the initial cardiac output increase was higher and vascular resistance did not change throughout gestation compared with reference values. Conclusions Hemodynamic changes in women who eventually develop hypertensive complications are substantially different. Serial monitoring and plotting against developed normograms can identify women at risk and may allow timely intervention. Tweetable abstract Monitoring haemodynamic changes in pregnancy helps identify women at risk for hypertensive complications.

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“…Timely detection of preeclampsia has been a major challenge in perinatal research for over 50 years. In 1947, Kraver et al attempted to predict the onset of preeclampsia by the cold pressor test or Hines-Brown test, by studying maternal cardiovascular changes following immersion of the hand in ice-cold water [ 67 ]. The last 20 years have seen extensive research on clinical parameters, biophysical markers (Doppler indices), and various early biochemical markers that reflect impaired placentation [ 68 – 72 ].…”

Section: Physiological Basis For Using Aspirin In Preeclampsiamentioning

confidence: 99%

Aspirin for Prevention of Preeclampsia

Atallah

Lecarpentier

Goffinet

et al. 2017

Drugs

160

110

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Aspirin is currently the most widely prescribed treatment in the prevention of cardiovascular complications. The indications for the use of aspirin during pregnancy are, however, the subject of much controversy. Since the first evidence of the obstetric efficacy of aspirin in 1985, numerous studies have tried to determine the effect of low-dose aspirin on the incidence of preeclampsia, with very controversial results. Large meta-analyses including individual patient data have demonstrated that aspirin is effective in preventing preeclampsia in high-risk patients, mainly those with a history of preeclampsia. However, guidelines regarding the usage of aspirin to prevent preeclampsia differ considerably from one country to another. Screening modalities, target population, and aspirin dosage are still a matter of debate. In this review, we report the pharmacodynamics of aspirin, its main effects according to dosage and gestational age, and the evidence-based indications for primary and secondary prevention of preeclampsia.

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The Value of the Cold Pressor Test in the Prediction of Hypertension and Toxæmia in Pregnancy

Cited by 7 publications

References 6 publications

The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

The Changes in the Intra-Arterial Pressure during Immersion of the Hand in Ice-Cold Water

Cardiac output and peripheral vascular resistance during normotensive and hypertensive pregnancy – a systematic review and meta‐analysis

Aspirin for Prevention of Preeclampsia

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