Studies in metabolism: The cold pressor test as a measure of vasomotor irritability

40 Pages·01.564 MB·English

by  Beals, Nels

STUDIES IN METABOLISM:
THE COLD PRESSOR TEST AS- A MEASURE OF VASOMOTOR
IRRITABILITY
A Thesis
Presented to
the Faculty of the Department of Zoology
The University of Southern California
In Partial Fulfillment
of the Requirements of the Degree
Master of Arts
by
Nels Beals
January 1950
UMI Number: EP67179
All rights reserved
INFORMATION TO ALL USERS
The quality of this reproduction is dependent upon the quality of the copy submitted.
In the unlikely event that the author did not send a complete manuscript
and there are missing pages, these will be noted. Also, if material had to be removed,
a note will indicate the deletion.
Dissertation Publishing
UMI EP67179
Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author.
Microform Edition © ProQuest LLC.
All rights reserved. This work is protected against
unauthorized copying under Title 17, United States Code
ProQuest LLC.
789 East Eisenhower Parkway
P.O. Box 1346
Ann Arbor, Ml 48106 - 1346
This thesis, written by
NELS BEALS •&3Cs C-
under the guidance of h.is... Faculty Committee, JT>Z,
and approved by all its members, has been
presented to and accepted by the Council on
Graduate Study and Research in partial fulfill­
ment of the requirements for the degree of
MASTER OF ARTS
Dean
Date...... January..l95.Q_
Faculty Committee
fej?.
CChhaaiirrmmaan
TABLE OF CONTENTS
PAGE
I. THE PROBLEM*......................... . . . 1
Statement of the problem* • • • • • * * • • 1
Justification of the problem........... . 1
Scope of the study* • « . * • • • * * • • • • 1
Organization of the remainder of the
thesis . • • • • • • • • •• 2
II. REVIEW OF RELATED LITERATURE ............ Z
The effect of age on response • • • • • • • 4
The effect of race on response. • • . • • • 5
The effect of race.............. . 6
The effect of anethesia • • • . • • • • • • 7
Vascular hyperreactrtffcy and latent hyper­
tension* . • • • • * • * • • • • • • . • • 7
Vascular hyperreactivity and essential
hypertension ♦ * . . . ♦ • • • • • • • • . 7
Mechanism of the cold pressor test. • • • • 11
III. METHOD OF STUDY. . . . . . . . . .......... 14
Apparatus • • • • • • • • • . . . 14
Method of operation ......... 14
of the subject. . . . . . . . . 15
histories. . • • • • • • • • • • • . * 15
IV. CRITIQUE OF METHOD AND DISCUSSION............ 16
V. RECORD AND RESULTS OF EXPERIMENTS. . . . . . 21
ii
CHAPTER PAGE
VI* SUMMARY* * * • • * • • ......... SO
BIBLIOGRAPHY . * .......... • • • • * • * * • • • « SI
LIST OF TABLES
TABLE PAGE
I. Arterial Pressure Rise Due to the Cold Pres­
sor Test of Seven Investigators............ 20
II. Arterial Pressure in the Supine Position,
Males, • ............. . • 22
III. Arterial Pressure in the Supine Position,
Females. ............ • • • • . • • • • . . 23
IV. The Cold Pressor Test, Males................. 2ft
V. The Cold Pressor Test, Females. ......... 25
VI. Arterial Pressure Rise Due to Application of
Cold, Males • • • « ........... 26
VII. Arterial Pressure Rise Due to Application of
Cold, Females 27
VIII. Effect of Different Agents on the Blood Pres­
sure Response to the Cold Test............ 28
IX. Response of Systolic Blood Pressure to Cold
Test......... 29
CHAPTER I
THE PROBLEM
Statement of the problem# This problem is an attempt
to study the reaction of the circulatory system when a por­
tion of it within the hand is subjected to cold conditions#
Justification of the problem# Since the cold pressor
test was first brought into prominence by Hines and Brown in
1932, it has been the center of much controversy as to its
merits# It was first held by Hines and Brown that the cold
pressor test was a standard test for predicting whether a
person would develop hypertension or not# Since their first
statement of the merits of the test, many investigators have
repeated the test with varying techniques and have found
disagreement in the conclusions of Hines and Brown. One
thing, however, has been common to all of these investigations
and that is that there is a change of blood pressure due to
the introduction of cold as used in the cold pressor test.
The purpose of this problem is to investigate the. blood pres­
sure changes resulting from the application of cold to a
portion of the body.
Scope of the study# This study was made upon thirty
people selected at random and includes both sexes and has a
wide range of ages# Only subjects who are considered nor-
2
xn&l reactors are included in this study
Organization of the remainder of the thesis. The re­
mainder of the thesis will consist of * (a) Review of the
related literature; (b) Method of study; (c) Critique of
method and discussion; (d) Record and results of experiments
t
M
and (e) Summary of the results of the problem.
CHAPTER II
REVIEW OF RELATED LITERATURE
There has been definite need for a standard stimulus
to measure responses in blood pressure and vasomotor irrit­
ability, Various procedures have been suggested and used, ~
Psychic and painful stimulation and electrical shocks have
been used but they have not been satisfactory; the reaction
of the subject Is too variable.
There are several purposes for seeking a standard sti­
mulus to increase blood pressure. The first purpose is to
group subjects according to the magnitude of their vasomotor
responses of vasomotor Irritability, The second purpose is
to ascertain,--if possible, whether a subject who is pre- -
disposed to hypertension has excessive vasomotor responses.
If such can be ascertained, new concepts in the treatment
8
of hypertension may be formulated.
Abnormal variability of the blood pressure is regarded
by many authors as one of the outstanding characteristics
of essential hypertension. In the opinion of Hines and Brown
vascular hyperreaction, in persons with normal blood pressure
means either a predisposition to hypertensive disease, or
previous hypertension which Is temporarily latent. Other
observers, similarly, have emphasized the prognostic sig­
nificance of even transient elevation of the blood pressure
4
In subjects who generally have normal levels.
Hyperreaction was found in 70.9 percent of the subjects
who were likely to develop hypertension, as compared with
only forty percent of those who were unlikely to develop it.sg
This difference is statistically significant, and clearly In­
dicates that hyperresponse is more common among subjects des­
tined to develop the disease. Nevertheless, the high inci­
dence of vascular hyperreaction among non-hypertensive sub­
jects makes it equally apparent that no specific correlation
exists between hyperresponse and subsequent hypertension.
In this regard, it should be noted that the older the group
considered, the less was the disparity in incidence of hyper­
reaction between the respective blood pressure groups. Vas­
cular hyperreaction, therefore, appears to arise, in later
life at least, from factors related to the aging process.®
The effect of age on response. Pickering and Kissin in
1956, stated that, among patients with usually normal blood
pressure the response of the pressure to stimulation by cold
increases with age, and that, among elderly persons, the
response of those who have essential hypertension is not
greater than is that of patients who usually have normal
blood pressure.18 However, these investigators studied
only nine elderly subjects with usually normal blood pressure
and only twelve patients with essential hypertension. It
is probably that in the investigation of Pickering and Kissin