The Pressor Response to the Drinking of Cold Water and Cold Carbonated Water in Healthy Younger and Older Adults.

Satoshi Kubota,Yutaka Endo,Mitsue Kubota,Tomohiko Shigemasa,Hiroko Miyazaki

doi:10.3389/fneur.2021.788954

Abstract

Purpose: Water drinking has been proposed for the treatment of orthostatic hypotension because it can increase blood pressure in patients. This study aimed to investigate whether drinking water with a cold or carbonation stimulus would cause a more effective pressor response, and whether it would be greater in older than in younger adults.Methods: We assessed blood pressure and heart rate from non-invasive arterial pressure (a volume-clamp method) and type II electrocardiography in 13 healthy young adults (6 females, 7 males; mean age, 19.9 ± 1.1 years) and nine healthy older adults (all females; mean age, 71.4 ± 4.2 years) who drank 200 mL of cold, cold carbonated, and room temperature water.Results: The pressor response to the drinking of cold and cold carbonated water was greater than that to room temperature water in both younger and older participants (p < 0.05; changes in systolic blood pressure of room temperature water, cold water and cold carbonated water in young: 15.31 ± 9.66, 22.56 ± 11.51 and 32.6 ± 17.98 mmHg, respectively; changes in systolic blood pressure of room temperature water, cold water and cold carbonated water in elderly: 21.84 ± 14.31, 41.53 ± 19.82 and 48.16 ± 16.77 mmHg, respectively). In addition, the pressor response to cold and cold carbonated water was persistent during the recovery period by about 5–10 mmHg (p < 0.05). Furthermore, the pressor response during the drinking and recovery periods was greater in the older than in the younger participants (p < 0.05).Conclusion: Our data suggest that even smaller amounts of water are able to elicit a sustained pressor response, in particular if the water is cold and carbonated. We speculate that the pressor effect may render cold and carbonated water an appropriate first aid method against certain forms of acute hypotension.

Highlights

Orthostatic hypotension (OH) is reported to be a risk factor for falls and mortality [1], making the development of methods to prevent OH a clinically critical challenge
In the linear mixed model (LMM) with water samples as fixed effects and participants as random intercepts, there was no main effect of water type on values (SBP, p = 0.9323; mean blood pressure (MBP), p = 0.9169; diastolic blood pressure (DBP), p = 0.6763; heart rate (HR), p = 0.1007)
The present study, which involved drinking 200 mL of water, had three major findings: [1] The pressor response to the drinking of cold and cold carbonated water was greater than that to room temperature water during the drinking period in both younger and older adults, especially that to cold carbonated water; [2] the pressor response to cold and cold carbonated water was persistent during the recovery period, and [3] the pressor response during the drinking and recovery periods was greater in the older than in the younger participants

Summary

Introduction

Orthostatic hypotension (OH) is reported to be a risk factor for falls and mortality [1], making the development of methods to prevent OH a clinically critical challenge. The potential risk of OH is especially high in the elderly patients, who may develop it just by sitting after 12 h or more of bed rest [3]. It is well known that elevated blood pressure occurs after water drinking in older patients and those with autonomic failure [5,6,7]. Drinking 500 mL of water at a time is recommended for the treatment of OH [2, 7, 9]. It is not easy for frail patients to drink this amount of water at once, we believe that a smaller amount would be more applicable

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