Aortic hemodynamics and arterial stiffness responses to muscle metaboreflex activation with concurrent cold pressor test

BACKGROUND Overweight/obese young men have increased sympatho-excitation to cold and pain stress-induced by the cold pressor test (CPT) that may lead to abnormal hemodynamic responses. Concurrent CPT and exercise may augment the sympathetic-induced increases in aortic blood pressure (BP), pressure wave reflection (augmentation index, AIx), and arterial stiffness (pulse wave velocity, PWV). Since obesity is related with hypertension and sympathetic activity, we evaluated the aortic hemodynamic and PWV responses to muscle metaboreflex activation imposed by postexercise muscle ischemia (PEMI) concurrent with CPT in overweight/obese men. METHODS In 16 healthy (body mass index >25 and <40kg/m²) men (24±2 years), heart rate (HR), brachial BP, aortic BP, augmented pressure (AP), AIx, AIx adjusted to 75 beats/min (AIx@75), reflection time (Tr), first (P1) and second systolic peak (P2, wave reflection magnitude), and PWV (brachial-ankle PWV, baPWV) were evaluated at baseline, during isometric-handgrip exercise (IHG), and PEMI with (PEMI + CPT) and without CPT. RESULTS During IHG, brachial BP, aortic BP, AP, AIx, AIx@75, P1, and P2 increased (P < 0.01) while Tr decreased (P < 0.05) compared with baseline. During PEMI, all hemodynamic parameters remained elevated (P < 0.05) and baPWV increased (P < 0.05) while Tr and HR returned to baseline. Compared with PEMI, the increases in HR, brachial BP, aortic BP, AIx@75, P1, P2, and baPWV were greater (P < 0.05) during PEMI + CPT. During PEMI + CPT, Tr remained lower (P < 0.05) than baseline. CONCLUSIONS Cold exposure with concurrent metaboreflex activation induces a significant increase in aortic hemodynamics and arterial stiffness, which may explain the high risk of adverse cardiovascular events during physiological stress.