Han Yue, Du Jun, Wang Jing, Liu Bin, Yan Yu-Ling, Deng Song-Bai, Zou Ya, Jing Xiao-Dong, Du Jian-Lin, Liu Ya-Jie, She Qiang
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Cardiovasc Med. 2022 Apr 25;9:860322. doi: 10.3389/fcvm.2022.860322. eCollection 2022.
To investigate the characteristics of patients with primary hypertension who had positive responses to the cold pressor test (CPT).
This cross-sectional study was conducted between November 2018 to November 2019, and the CPT was performed in patients with primary hypertension in 48 hospitals. The demographic characteristics and complications were collected through a questionnaire and physical examinations. A 12-month follow-up was conducted to identify the occurrence of the following events: a) all-cause mortality; b) myocardial infarction; c) stroke; d) hospitalized for heart failure.
The CPT was positive in 30.7% of the patients. Compared with the negative CPT group, the positive CPT group was associated with a lower rate of blood pressure control, and was more likely to have a high salt diet, diabetes, hyperuricemia, left ventricular wall thickening, carotid plaques, coronary heart disease and heart failure. A high-salt diet (OR = 1.228, 95%CI: 1.037-1.456) was found to be correlated with the positive result of CPT. Among patients in the positive CPT group, those using diuretics had a significantly higher rate of blood pressure control than those not using diuretics (54.6 vs.42.6%, x = 6.756, = 0.009). After a 12-month follow-up, the incidence of heart failure in the positive CPT group was significantly higher than that in the negative CPT group (7.35 vs.5.01%, x = 3.945, = 0.047).
Patients with positive responses to the CPT had lower rates of BP control and a high risk of heart failure, which may be related to their preference for a high-salt diet. The use of diuretics helps to better control blood pressure in those patients.
探讨对冷加压试验（CPT）有阳性反应的原发性高血压患者的特征。
本横断面研究于2018年11月至2019年11月进行，在48家医院对原发性高血压患者进行CPT。通过问卷调查和体格检查收集人口统计学特征和并发症。进行为期12个月的随访，以确定以下事件的发生情况：a）全因死亡率；b）心肌梗死；c）中风；d）因心力衰竭住院。
30.7%的患者CPT呈阳性。与CPT阴性组相比，CPT阳性组血压控制率较低，更有可能有高盐饮食、糖尿病、高尿酸血症、左心室壁增厚、颈动脉斑块、冠心病和心力衰竭。发现高盐饮食（OR = 1.228，95%CI：1.037 - 1.456）与CPT阳性结果相关。在CPT阳性组患者中，使用利尿剂的患者血压控制率明显高于未使用利尿剂的患者（54.6%对42.6%，x = 6.756，P = 0.009）。经过12个月的随访，CPT阳性组心力衰竭的发生率明显高于CPT阴性组（7.35%对5.01%，x = 3.945，P = 0.047）。
对CPT有阳性反应的患者血压控制率较低且心力衰竭风险高，这可能与其高盐饮食偏好有关。使用利尿剂有助于更好地控制这些患者的血压。
