title: Increased blood pressure response to the cold pressor test in pregnant women developing pre-eclampsia.
abstract: OBJECTIVE
  Recent data indicate an increased vascular reactivity due to an overactivity of the sympathetic nervous system in women with pre-eclampsia. We therefore evaluated whether this increased vascular reactivity can be detected prior to the clinical manifestation of preeclampsia by the use of a physiological stimulus.
  
  
  METHODS
  Prospective data collection.
  
  
  METHODS
  Clinic of Obstetrics and Gynecology in a 2000 bed tertiary care hospital.
  
  
  METHODS
  One hundred and twenty-three pregnant women between the 16th to 20th week of gestation.
  
  
  METHODS
  A cold pressor test was performed by positioning an ice-bag on the forehead of the woman for 3 min. Blood pressure and heart rate were monitored by a continuous, noninvasive blood pressure measurement device during the stimulus and after removal of the icebag. A clinical follow-up was carried out by review of the charts after delivery to identify those women who have developed pre-eclampsia.
  
  
  RESULTS
  Ten (8%) out of 123 pregnant women developed pre-eclampsia. During the cold pressor test systolic as well as diastolic blood pressure increased significantly and was more pronounced in women developing pre-eclampsia compared with healthy pregnant women (systolic blood pressure: 14.2 +/- 5.5 versus 8.5 +/- 7.2 mmHg, P= 0.02; diastolic blood pressure: 7.3 +/- 4.9 versus 3.9 +/- 4.7 mmHg, P=0.03). The change in heart rate was similar between both groups (8 +/- 2.6 versus 10.4 +/- 6.4 beats/min, not significant).
  
  
  CONCLUSIONS
  An increased vasoconstrictive response to a physiological stimulus is present in women with pre-eclampsia as a sign of an increased vascular reactivity prior to clinical manifestation of the disease. The cold pressor test may be a suitable diagnostic tool to identify women, who will develop pre-eclampsia. However, future studies in larger cohorts are required to establish the final value of this test.
authors.affiliation: Department of Emergency Medicine, University of Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Woisetschläger
authors.forename: U
authors.initials: U
authors.lastname: Waldenhofer
authors.forename: A
authors.initials: A
authors.lastname: Bur
authors.forename: H
authors.initials: H
authors.lastname: Herkner
authors.forename: H
authors.initials: H
authors.lastname: Kiss
authors.forename: M
authors.initials: M
authors.lastname: Binder
authors.forename: A N
authors.initials: AN
authors.lastname: Laggner
authors.forename: M M
authors.initials: MM
authors.lastname: Hirschl
mesh_terms: D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D003080:Cold Temperature; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010298:Parity; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy