This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Antony, I. Articles by Nitenberg, A. Search for Related Content PubMed PubMed Citation Articles by Antony, I. Articles by Nitenberg, A.

Hypertension, Vol 24, 212-219, Copyright © 1994 by American Heart Association

ARTICLES

Coronary artery constriction caused by the cold pressor test in human hypertension

I Antony, E Aptecar, G Lerebours and A Nitenberg
Service d'Explorations Fonctionnelles, Centre Hospitalier et Universitaire Xavier Bichat, Paris, France.

Hypertensive patients with angiographically normal coronary arteries may have myocardial ischemia when metabolic demand increases. Abnormal epicardial coronary artery vasomotion in response to sympathetic stimulation may contribute to ischemia in such patients. We studied the vasomotor response of smooth coronary arteries to a cold pressor test in 10 hypertensive patients without other risk factors and in 9 control subjects. Vessel dimensions were measured by quantitative angiography, and blood flow was calculated using an intracoronary Doppler catheter in the left anterior descending coronary artery. In response to cold pressor stimulation, arteries of control subjects dilated 13.0 +/- 5.9% (P < .001), and they constricted 8.2 +/- 8.5% in hypertensive patients (P < .001). Rate-pressure product increased from 9466 +/- 1677 to 12,547 +/- 2367 beats per minute (bpm).mm Hg in control subjects (P < .001) and from 13,720 +/- 1823 to 17,353 +/- 2037 bpm.mm Hg in hypertensive patients (P < .001). Coronary blood flow velocity and blood flow increased 51 +/- 26% (P < .05) and 87 +/- 27% (P < .001), respectively, in control subjects and 68 +/- 52% (P < .05) and 36 +/- 33% (P < .01) in hypertensive patients. At peak cold pressor test, despite a significant higher rate-pressure product in hypertensive patients, blood flow was similar in both groups, suggesting an uncoupling between myocardial metabolic demand and supply. Thus, hypertension impairs the vasodilator response of angiographically normal coronary arteries to a cold pressor test. This abnormal response may be due to enhanced catecholamine reactivity and/or impairment of endothelial flow-mediated vasodilator response.

This article has been cited by other articles:

				K. F. Harris and K. A. Matthews Interactions Between Autonomic Nervous System Activity and Endothelial Function: A Model for the Development of Cardiovascular Disease Psychosom Med, March 1, 2004; 66(2): 153 - 164. [Abstract] [Full Text] [PDF]

				A. Nitenberg, P. Valensi, R. Sachs, E. Cosson, J.-R. Attali, and I. Antony Prognostic Value of Epicardial Coronary Artery Constriction to the Cold Pressor Test in Type 2 Diabetic Patients With Angiographically Normal Coronary Arteries and No Other Major Coronary Risk Factors Diabetes Care, January 1, 2004; 27(1): 208 - 215. [Abstract] [Full Text] [PDF]

				S. H. Golden, N.-Y. Wang, M. J. Klag, L. A. Meoni, and F. L. Brancati Blood Pressure in Young Adulthood and the Risk of Type 2 Diabetes in Middle Age Diabetes Care, April 1, 2003; 26(4): 1110 - 1115. [Abstract] [Full Text] [PDF]

				N. H. Buus, M. Bottcher, F. Hermansen, M. Sander, T. T. Nielsen, and M. J. Mulvany Influence of Nitric Oxide Synthase and Adrenergic Inhibition on Adenosine-Induced Myocardial Hyperemia Circulation, November 6, 2001; 104(19): 2305 - 2310. [Abstract] [Full Text] [PDF]

				T.-M. Lee, S.-F. Su, W.-Y. Suo, C.-Y. Lee, M.-F. Chen, Y.-T. Lee, and C.-H. Tsai Distension of urinary bladder induces exaggerated coronary constriction in smokers with early atherosclerosis Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H2838 - H2845. [Abstract] [Full Text] [PDF]

				T.-M. Lee, S.-F. Su, M.-F. Chen, and C.-H. Tsai Acute effects of urinary bladder distention on the coronary circulation in patients with early atherosclerosis J. Am. Coll. Cardiol., August 1, 2000; 36(2): 453 - 460. [Abstract] [Full Text] [PDF]

				D. Chemla, E. Aptecar, J.-L. Hebert, C. Coirault, D. Loisance, Y. Lecarpentier, and A. Nitenberg Short-term variability of pulse pressure and systolic and diastolic time in heart transplant recipients Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H122 - H129. [Abstract] [Full Text] [PDF]

				I. Antony, G. Lerebours, and A. Nitenberg Angiotensin-Converting Enzyme Inhibition Restores Flow-Dependent and Cold Pressor Test–Induced Dilations in Coronary Arteries of Hypertensive Patients Circulation, December 15, 1996; 94(12): 3115 - 3122. [Abstract] [Full Text]

				I. Antony, G. Lerebours, and A. Nitenberg Loss of Flow-Dependent Coronary Artery Dilatation in Patients With Hypertension Circulation, March 15, 1995; 91(6): 1624 - 1628. [Abstract] [Full Text]