title: Blood Pressure Reactivity to the Cold Pressor Test Predicts Hypertension Among Chinese Adults: The GenSalt Study.
abstract: BACKGROUND
  Blood pressure (BP) hyper-reactivity to the cold pressor test (CPT) has been suggested as a predictor of hypertension. We examined whether BP reactivity to the CPT was associated with hypertension incidence among the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study participants from China.
  
  
  METHODS
  A total of 1,961 GenSalt study participants without any antihypertensive treatment completed the CPT at the baseline examination. Hypertension status was assessed at baseline (2003-2005) and 2 follow-up visits (2008-2009 and 2011-2012).
  
  
  RESULTS
  After adjustment for multiple covariates, both systolic BP (SBP) and diastolic BP reactivity to the CPT were significantly associated with hypertension incidence. For example, the multivariable adjusted odds ratios (ORs, 95% CI) of developing hypertension were 0.92 (0.66, 1.29), 1.42 (1.03, 1.97), and 1.45 (1.05, 2.00) for participants with maximum SBP responses of 6.7-12.0, 12.1-19.2, and ≥19.3mm Hg, respectively, compared to those with responses of <6.7mm Hg (P for trend = 0.006). Likewise, the multivariable-adjusted ORs (95% CI) of hypertension were 1.12 (0.79, 1.57), 1.62 (1.15, 2.29), and 1.82 (1.30, 2.55) for participants with the area under the curve of SBP responses of 3.0-16.0, 16.1-29.9, and ≥ 30.0mm Hg·min, respectively, compared to those with responses of < 3.0mm Hg·min (P for trend = 0.0001). The associations between BP reactivity variables and the risk of hypertension were not different among subgroups of sex, age, and baseline BP levels.
  
  
  CONCLUSIONS
  BP hyperreactivity to the cold stimulus may predict the risk of hypertension among Chinese adults.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA; qizhao@tulane.edu.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: State Key Laboratory of Cardiovascular Disease and Department of Epidemiology and Population Genetics, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Gu
authors.affiliation: Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, China;
authors.forename: Fanghong
authors.initials: F
authors.lastname: Lu
authors.affiliation: First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China;
authors.forename: Jianjun
authors.initials: J
authors.lastname: Mu
authors.affiliation: Center for Disease Control and Prevention of Ganyu County, Ganyu, Jiangsu, China;
authors.forename: Xushan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Xinle Traditional Medicine Hospital, Xinle, Hebei, China;
authors.forename: Xu
authors.initials: X
authors.lastname: Ji
authors.affiliation: Shenzhen University Medical Center, Shenzhen, Guangdong, China;
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Hu
authors.affiliation: National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China;
authors.forename: Jixiang
authors.initials: J
authors.lastname: Ma
authors.affiliation: State Key Laboratory of Cardiovascular Disease and Department of Epidemiology and Population Genetics, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Huang
authors.affiliation: State Key Laboratory of Cardiovascular Disease and Department of Epidemiology and Population Genetics, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
authors.forename: Jianxin
authors.initials: J
authors.lastname: Li
authors.affiliation: State Key Laboratory of Cardiovascular Disease and Department of Epidemiology and Population Genetics, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
authors.forename: Jichun
authors.initials: J
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cardiovascular Disease and Department of Epidemiology and Population Genetics, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
authors.forename: Jie
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA;
authors.forename: Chung-Shiuan
authors.initials: CS
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA;
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: Treva K
authors.initials: TK
authors.lastname: Rice
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA;
authors.forename: Jiang
authors.initials: J
authors.lastname: He
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D003080:Cold Temperature; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010812:Physical Stimulation / Q000379:methods; D011237:Predictive Value of Tests; D011312:Pressure; D011379:Prognosis; D012307:Risk Factors; D013564:Sympathetic Nervous System / Q000503:physiopathology
keywords: blood pressure; hypertension; risk factors; stress; sympathetic nervous system.
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