Pathophysiological characteristics of labile hypertensive patients determined by the cold pressor test.

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Abstract
Hemodynamic changes during the cold pressor test were examined in type I labile (juvenile labile) hypertensive patients, type II labile (middle aged labile) hypertensive patients, established hypertensive patients and normal subjects. In normal type I labile hypertensive and established hypertensive subjects, the pressor response during the test was chiefly due to a rise in peripheral resistance. In type II labile hypertensive patients an increase in blood pressure during cold stimuli was accompanied by an augmented cardiac output. Type II labile hypertension is separated clearly from other types of hypertension with respect to hemodynamic changes during the test. In type II labile hypertensive patients, diazepam reduced an increase in cardiac output during the test, causing hemodynamic changes similar to those of normal subjects. After atropinization the hemodynamic pattern of Type I and established hypertensives changed similar to that of Type II labile patients during the cold pressor test. An excessive cardiac output caused by the cold stimuli is a distinctive hemodynamic characteristic of type II labile hypertensive patients; this distinctive hemodynamic characteristic might be due to the decreased parasympathetic tone.

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