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C.L. Prokopich, J.G. Flanagan; The Association Between a Positive Cold Pressor Test and Vasospastic Symptoms . Invest. Ophthalmol. Vis. Sci. 2003;44(13):116.
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Purpose: To investigate the association between vasospastic symptoms and a positive cold pressor test. Methods: Ten young subjects with a reported history of abnormally cold hands and age and gender matched controls (31.8±7.9; range 22.9 to 42.1 years) were evaluated using the cold pressor test. A laser Doppler probe (Transonic Systems Inc.) was attached to the middle finger of the right hand. Baseline flow was recorded for a minimum of 5 minutes. The hand was then immersed in warm water for 2 minutes. The flow was monitored until a maximum was reached after which time the hand was immersed in ice cold water (4°C) for 10 seconds. The flow was monitored for 10 minutes and recorded when it reached a minimum. Blood pressure was also recorded from the middle finger of the opposite hand (Finapres 2300). Subjects were classified according to the method of Drance et al whereby a ratio of the maximum warm flow over the cold flow equal to or exceeding 7 was considered to have a "vasospastic response to cold". A questionnaire was used to establish vasospastic symptomology and systemic associations. Results: The difference between the groups was significant (p=0.001) for baseline finger flow with an average of 6.6±1.4 tissue perfusion units (TPU) for the vasospastic group and 22.3 ±7.3 TPU for the normal group. The response to warm was not significantly different (p=0.71). The difference in the response to cold was significant (p=0.04) with an average flow of 3.4±1.0 TPU for the vasospastic group and 11.2±10.2 TPU for the normal group. The entire symptomatic group (ratio 11.3 ±2.6; range 8.6 to 12.9) and 4 of 9 of the normal group (ratio 5.9 ±3.9; range 1.0 to 12.1) demonstrated a vasospastic response. The difference between groups was significant (p=0.007). Of the 4 normal subjects with a vasospastic response (7.3, 7.6, 11.0,12.1), one (11.0) reported a history of ocular migraine and experienced a hypertensive episode during the experiment. A second subject (7.3) had a family history of Raynaud’s syndrome. Conclusions: We have established a link between reported symptoms of "abnormally" cold hands and the clinical classification of a vasospastic response to cold in a young, female sample.
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