Gender differences in pain and cardiovascular responses to forearm ischemia.

Abstract

To examine gender-related differences in pain and cardiovascular responses to forearm ischemia. Forearm ischemia was produced by the submaximal effort tourniquet procedure. Participants performed 2 min of dynamic hand exercise at 30% maximum grip strength. Forearm ischemia was maintained until the report of ischemic pain tolerance or until 20 min elapsed. Arterial blood pressure, heart rate, and verbal reports of ischemic pain were assessed at 2 min intervals. Thirty four male and 33 female participants of similar age. The times to ischemic pain onset and ischemic pain tolerance were similar for both male and female participants. However, during the ischemic period, females reported ischemic pain to be more intense and of greater unpleasantness than male participants. The relative changes in arterial blood pressure and heart rate during the exercise and occlusion period were equivalent for both male and female participants. In contrast, arterial blood pressure responses during the postexercise ischemic period were gender-dependent. Arm ischemia evoked pressor responses in male participants and either a decrease or no change in arterial pressure in female participants. Changes in arterial pressure during the postexercise ischemic period were significantly and positively correlated with verbal measures of ischemic pain for male subjects but not for female subjects. The data demonstrated that gender influences both the sensory and the cardiovascular responses to a tonic noxious stressor.