Int J Med Sci 2013; 10(7):848-856. doi:10.7150/ijms.5967

Research Paper

Hemodynamic Reactivity to Laboratory Stressors in Healthy Subjects: Influence of Gender and Family History of Cardiovascular Diseases

Giovana M. S. Simoes1, Bianca P. Campagnaro2, Clarissa L. Tonini2, Silvana S. Meyrelles2, Fatima H. Sert Kuniyoshi3, Elisardo C. Vasquez1,2,✉

1. Emescam College of Health Sciences, Vitoria, ES, Brazil;
2. Department of Physiological Sciences, Health Sciences Center, Federal University of Espirito Santo, Vitoria, ES, Brazil;
3. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.


Although laboratory stressor tests have been applied as a preliminary protocol in some cardiovascular studies, there is a lack of data comparing the pressor and chronotropic responses among the main stressor tests. Therefore, the aim of this study was to evaluate the variability in hemodynamic responsiveness to the main stressor tests, establish a hyperresponsiveness cutoff criterion and analyze the influence of gender and family history of cardiovascular diseases (CVDs) in healthy subjects. We examined hemodynamic responses to physical (cold pressor and handgrip tests) and mental (Stroop color-word test) stressors in 98 subjects (48 males and 50 females) without CVDs. All stressor tests resulted in increased blood pressure (BP) levels, which were lower and less dispersed in the handgrip test compared to the cold pressor test. Adopting the 75th percentile as the cutoff in our data, we classified subjects exhibiting absolute pressor changes equal to or higher than 14, 24 and 36 mmHg in systolic and 9, 13 and 24 mmHg in diastolic BP during the handgrip, Stroop and cold pressor test, respectively, as hyperresponsives. Males exhibited greater (p<0.05) increases in systolic BP in the handgrip (11% vs. 8%) and cold pressor (25% vs. 21%) tests and in diastolic BP in the handgrip (12% vs. 7%) and Stroop (22% vs. 19%) tests than females. A positive association between family history of CVDs and pressor hyperreactivity to stressor tests was observed. We propose using the 75th percentile of hemodynamic sample values as a cutoff criterion to classify individuals as pressor or chronotropic hyperreactives. We conclude that hemodynamic responsiveness to stressor tests in healthy subjects is positively influenced by male gender and family history of CVDs.

Keywords: stressor test, handgrip test, Stroop test, Cold pressor test, blood pressure, heart rate.

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How to cite this article:
Simoes GMS, Campagnaro BP, Tonini CL, Meyrelles SS, Kuniyoshi FHS, Vasquez EC. Hemodynamic Reactivity to Laboratory Stressors in Healthy Subjects: Influence of Gender and Family History of Cardiovascular Diseases. Int J Med Sci 2013; 10(7):848-856. doi:10.7150/ijms.5967. Available from