Blood pressure reactions to the cold pressor test and the prediction of ischaemic heart disease: data from the Caerphilly Study.

The prognostic significance of the cold pressor test for cardiovascular disease remains a matter of controversy. Only two studies have specifically tackled the issue of whether large blood pressure reactions to brief hand immersion in cold water are associated with increased risk for coronary heart disease. In one, the magnitude of diastolic reactions to the cold pressor test was reported to be the most significant single predictor of 20 year incident coronary heart disease in a sample of 279 middle aged men. In the other, however, neither systolic or diastolic reactions to cold pressor were related to coronary heart disease in a sample of 905 ex-medical students followed up for 24–40 years. The administration of the cold pressor test to participants in the Caerphilly Collaborative Heart Disease Study provided an opportunity to help resolve matters.