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

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 accounted for chiefly by 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. Therefore, 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, however, diazepam reduced an increase in cardiac output during the test, resulting in 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. It is concluded that an excessive cardiac output caused by the cold stimuli is a distinctive hemodynamic characteristics of Type II labile hypertensive patients, and this distinctive hemodynamic characteristics might be due to the decreased parasympathetic tone.